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Chronic Pelvic Pain In Women

 Syn. CPP in women

Signs & Symptoms

 Somatic sensitivity
Ref: Uptodate [ Evaluation of chronic pelvic pain in females: epidemiology and pathogenesis]
Weakness in the pelvic area (negative symptom)
Ref: Uptodate [ Clinical presentation]
History of Physical abuse
Ref: Uptodate [ Evaluation of chronic pelvic pain in females: epidemiology and pathogenesis] Epocrates [ Chronic pelvic pain in women: epidemiology]
Marital discord
Ref: Epocrates [ Chronic pelvic pain in women: epidemiology]

Physical Examination

 Abdominal trigger points
Note: Typically at the lateral margin of the rectus sheath or an old scar
Ref: Epocrates [ Key highlights/vignette/key factors]
Unilateral Levator ani tenderness
Note: Often unilateral
Ref: Uptodate [ Clinical presentation] Epocrates [ Key highlights/vignette/key factors]
Cervical motion tenderness
Note: Indicates upper pelvic organs are likely involved: uterus,ovaries. may also occurs with bladder pain
Ref: Uptodate [ Clinical presentation] Epocrates [ Key highlights/vignette/key factors]

Lab / Serology

 Active urineanalysis (negative symptom)
Ref: Uptodate [ Targeted testing] Epocrates [ Tests]
Bacterial growth
Ref: Uptodate [ Targeted testing] Epocrates [ Tests]
Bacteriuria (negative symptom)
Ref: Uptodate [ Targeted testing] Epocrates [ Tests]

Imagin Study

 Adenomyosis
Note: Is defined as the presence of endometrial glands and stroma inside the uterine wall
Ref: Uptodate [ Evaluation of chronic pelvic pain in females: epidemiology and pathogenesis] Epocrates [ Definition/Etiology/pathophysiology]
Uterine leiomyomas
Ref: Uptodate [ Targeted testing] Epocrates [ Tests]
Ovarian mass
Ref: Uptodate [ Targeted testing] Epocrates [ Tests]

Complication

Risk Factors

 Age < 35
Ref: Epocrates [ Chronic pelvic pain in women: epidemiology]
White race
Ref: Epocrates [ Chronic pelvic pain in women: epidemiology]

Cause

 Leiomyoma
Ref: Uptodate [ Evaluation of chronic pelvic pain in females: epidemiology and pathogenesis] Epocrates [ Definition/Etiology/pathophysiology]
Vulvodynia
Note: due to Persistent vulva pain
Ref: Epocrates [ Definition/pathophysiology]
Endometriosis
Note: Defined as presence of endometrial glandsand stroma outside of the uterine lining
Ref: Uptodate [ Evaluation of chronic pelvic pain in females: epidemiology and pathogenesis] Epocrates [ Definition/Etiology/pathophysiology]

Other