Chronic pelvic pain: Pathogenesis and validated assessment

Publication date: Available online 23 September 2016 Source:Middle East Fertility Society Journal Author(s): Ali Yosef, Abdel Ghaffar Ahmed, Tarek Al-Hussaini, Mohamad S. Abdellah, Georgine Cua, Mohamed A. Bedaiwy Chronic pelvic pain (CPP) is a disabling disease that causes distress as the quality of life of CPP patients is vastly diminished. In addition, CPP is a public health crisis and is a burden on healthcare expenditure. In the United States, the annual costs for the diagnosis and treatment of CPP are 2.8 billion US $. Moreover, to the indirect cost resulting from the absence from work and CPP associated family problems add 550 million US $ more making the economic burden more than 3.4 billion US $ (Mathias et al., 1996). Yet, the diagnosis of CPP is usually complicated as there are no gold standard guidelines that clearly define this syndrome. Although we have a limited understanding of its etiology, CPP has been found to be correlated with central sensitization, painful bladder syndrome, irritable bowel syndrome, endometriosis and adhesions. As such, in the evaluation of patients, it is imperative to take a comprehensive patient history. Performing physical examinations and ultrasound imaging is of particular value to elucidate the etiology of pain. As CPP patients are at risk for psychological disorders, psychological assessments are critical to diagnose associated psychological disorders and to take these into account in planning a holistic treatment plan for patie...
Source: Middle East Fertility Society Journal - Category: Reproduction Medicine Source Type: research

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Chronic pelvic pain (CPP) is a frequent health problem in women during childbearing age. Etiology of CPP includes irritable bowel syndrome, endometriosis, adenomyosis, pelvic congestion syndrome, urological disorders and psychosocial issues.
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Tags: IMAGES IN Gynecological Surgery Source Type: research
Abstract Neurotrophins (NTs), particularly Nerve Growth Factor (NGF) and Brain Derived Neurotrophic Factor (BDNF), have attracted increasing attention in the context of visceral function for some years. Here, we examined current literature and produced a thorough review on the subject. After initial studies linking NGF to cystitis, it is now well-established that this neurotrophin (NT) is a key modulator of bladder pathologies, including Bladder Pain Syndrome/Interstitial Cystitis (BPS/IC) and Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS. NGF is upregulated in bladder tissue and its blockade results i...
Source: Current Neuropharmacology - Category: Drugs & Pharmacology Authors: Tags: Curr Neuropharmacol Source Type: research
Semin Reprod Med 2018; 36: 116-122 DOI: 10.1055/s-0038-1676088Dysmenorrhea and noncyclic pelvic pain (chronic pelvic pain) are common in adolescents. The evaluation of teens with dysmenorrhea or chronic pelvic pain is aimed to diagnose possible gynecologic conditions (endometriosis, pelvic inflammatory disease, ovarian cysts, and obstruction of the reproductive tract) and nongynecologic conditions (irritable bowel syndrome, interstitial cystitis, and myofascial pain). The management of chronic pelvic pain in adolescents is often more complex than in adult women because both the adolescent and her parents are counseled and ...
Source: Seminars in Reproductive Medicine - Category: Reproduction Medicine Authors: Tags: Review Article Source Type: research
Over the last decade, much effort has been put into exploring the relationship and causality between multiple chronic diagnoses in adults, especially female adults. This research often includes endometriosis and many studies have shown increased prevalence of fibromyalgia, interstitial cystitis, irritable bowel syndrome, and migraines in patients with endometriosis compared to their counterparts without endometriosis (1). These studies have all been conducted in adult populations with a mean age usually in the 30-40  year range.
Source: Fertility and Sterility - Category: Reproduction Medicine Authors: Tags: Reflections Source Type: research
we found that 45% of UK gynaecologists think that chronic pelvic pain (CPP) is managed badly. CPP affects 38/1000 women annually in the UK and global estimates range from 2.1 –24% of the female population [1,2]. Endometriosis, adenomyosis, adhesions, pelvic inflammatory disease, irritable bowel syndrome, bladder pain syndrome, nerve entrapment, and musculoskeletal pain are among the common causes [1]. Timely diagnosis and treatment of CPP is crucial to avoid unnecessar y referrals, investigations and surgical procedures [3,4].
Source: European Journal of Obstetrics, Gynecology, and Reproductive Biology - Category: OBGYN Authors: Tags: Correspondence Source Type: research
There are few subjects that can stir up stronger emotions among doctors, scientists, researchers, policy makers, and the public than medical marijuana. Is it safe? Should it be legal? Decriminalized? Has its effectiveness been proven? What conditions is it useful for? Is it addictive? How do we keep it out of the hands of teenagers? Is it really the “wonder drug” that people claim it is? Is medical marijuana just a ploy to legalize marijuana in general? These are just a few of the excellent questions around this subject, questions that I am going to studiously avoid so we can focus on two specific areas: why do...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Complementary and alternative medicine Drugs and Supplements Health Pain Management Source Type: blogs
This study comprised 9191 subjects with endometriosis, and 27 573 subjects randomly selected as controls. We individually followed‐up each subject (n = 36 764) for a 3‐year period to identify subjects subsequently diagnosed with BPS/IC. A Cox proportional hazards regression model was employed to estimate the risk of subsequent BPS/IC following a diagnosis of endometriosis. ResultsIncidences of BPS/IC during the 3‐year follow‐up period was 0.2% and 0.05% for subjects with and without endometriosis, respectively. The hazard ratio for developing BPS/IC over a 3‐year period for subjects wi...
Source: Neurourology and Urodynamics - Category: Urology & Nephrology Authors: Tags: ORIGINAL CLINICAL ARTICLE Source Type: research
Abstract: Fibromyalgia syndrome (FMS) is a central sensitization syndrome; however, peripheral pain sources potentially exacerbate its symptoms of chronic diffuse musculoskeletal pain and hyperalgesia. This prospective study evaluated visceral pain as a possible triggering factor for FMS pain and hyperalgesia in comorbid patients. Women with (1) FMS + irritable bowel syndrome (IBS); (2) FMS + primary dysmenorrhea (Dys); (3) FMS + Dys secondary to endometriosis (Endo); (4) FMS + colon diverticulosis (Div) were compared with FMS-only women, for fibromyalgia pain (number and intensity of episodes and analgesic consumption) ov...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research
Sometime back in 2010, a good friend of mine from college who had since become a pediatrician posted a complaint on Facebook about “made up” health conditions. “Fibromyalgia, I’m looking at you,” she wrote. At this time, pain was more of an occasional visitor in my body rather than the permanent tenant it has since become. Still, I was offended on behalf of those patients with the disease. Fast forward to today and my life is all about pacing. This is because everything I do — cook, sleep, work, walk — takes time. This gradual approach to every aspect of my life is not about enligh...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Managing your health care Pain Management Source Type: blogs
Publication date: Available online 20 August 2016 Source:Journal of the Chinese Medical Association Author(s): Sen-Wen Teng, Huann-Cheng Horng, Chi-Hong Ho, Ming-Shyen Yen, Hsiang-Tai Chao, Peng-Hui Wang Endometriosis, defined by the presence of viable extrauterine endometrial glands and stroma, can grow or bleed cyclically, and possesses characteristics including a destructive, invasive, and metastatic nature. Since endometriosis may result in pelvic inflammation, adhesion, chronic pain, and infertility, and can progress to biologically malignant tumors, it is a long-term major health issue in women of reproductive age. ...
Source: Journal of the Chinese Medical Association - Category: Journals (General) Source Type: research
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