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Pelvic painTereza Indrielle, ST1
Incidence4 in 100Asthma or back pain
Causes1. 2. 3. 4. 5.
Causes – gynae ONLY
1. endometriosis2. adhesions3. PID4. ovarian cyst5. psychogenic
Endometriosis
Endometriosis - stages
DiagnosisMacroscopicNot very accurate
TREATMENT
Stop periodsBurn it – might help or not (central sensitisation of NS established – pain continues)
Resect it
Adhesions
PID
Episode of PID -> 20%chronic painFitz - Hugh – Curtis SY
Ovarian cyst
PSYCHOGENIC
Psychosocial influence (Mathias et al. 1996 – separated, widowed and divorced more likely to have CPP and more likely to report it)
60% NO DIAGNOSIS
Antidepressants ineffective