Chronic pelvic pain

Chronic pelvic pain (CPP) is a common condition in women of reproductive age affecting up to 1 in 4 women. This is an intermittent or constant pain in the pelvis or the lower abdomen of at least 6 months duration.

Findings in women with CPP

• Adhesions- may be caused by previous surgery, endometriosis or previous pelvic infection (chlamydeous pelvic inflammatory disease)
  
  
• Endometriosis
  
  
• Pelvic inflammatory disease (PID)
  
  
• Irritable bowel syndrome
  
  
• Interstitial cystitis
  
  
• Musculoskeletal /nerve entrapment
  
  
• 'No pathology'

A multidisciplinary approach to CPP has been shown to be effective in reducing pain and in improving work and social functioning. The team will include a gynaecologist, clinical psychologist, pain physician and specialist nurse.

Investigations

Laparoscopy - Able to diagnose adhesions, PID and endometriosis. Irritable bowel syndrome and adenomyosis (endometriosis in the muscle wall of the uterus) will not be detected.

Ultrasound - to exclude ovarian cysts or an endometrioma

Treatment

This is based on the history, examination and Laparoscopic findings