Pelvic neuropathic pain (differential diagnosis)

2021 ◽  
Vol 86 (4) ◽  
pp. 279-283
Author(s):  
Tomáš Fučík ◽  
◽  
Jaromír Mašata
Keyword(s):  
Differential Diagnosis ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Diagnostic Algorithm ◽  
International School ◽  
Functional Disorders ◽  
Review Of Literature ◽  
Acute Pelvic Pain ◽  
Time To Diagnosis ◽  
Common Etiology

Summary: Objective: General practitioners, surgeons, neurologists, urologists and gynecologists all encounter patients suffering from neurogenic pelvic pain. Correct management demands knowledge from all above mentioned specialties. The primary goal is to help patients suffering from chronic or acute pelvic pain coupled with functional disorders like dysuria, urgency, dyspareunia, mobility disorders orhypoesthesia. Neurogenic defects are not the most common etiology for either of listed symptoms. However, after exclusion of the more common ones and failure to respond to basic therapeutic methods such as physiotherapy or analgotheraphy doctors tend to mark the illness as idiopathic and incurable. The goal of this review is to show the most common nosological units and a robust diagnostic algorithm to describe the type and level of the damage. Methods: Review of literature using databases Pubmed, Science direct, Medline and sources of the international school of neuropelveology. Conclusion: Over a lifetime, one in seven women will suffer from chronic pelvic pain. Outside of the cases where a clear postoperative etiology is established, the time to make a correct dia gnosis is often long for the unspecific and varied symptomatology. Neuropelveological diagnostic algorithm is demonstrably efficient in shortening the time to diagnosis and more importantly to the treatment.

scholarly journals Endometriosis and chronic pelvic pain have similar impact on women, but time to diagnosis is decreasing: an Australian survey

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Mike Armour ◽  
Justin Sinclair ◽  
Cecilia H. M. Ng ◽  
Mikayla S. Hyman ◽  
Kenny Lawson ◽  
...  
Keyword(s):  
Romantic Relationships ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Online Survey ◽  
Negative Impact ◽  
Treatment Options ◽  
Diagnostic Delay ◽  
Time To Diagnosis ◽  
Significant Negative Impact ◽  
The Impact

Abstract Chronic pelvic pain (CPP) affects a significant number of women worldwide. Internationally, people with endometriosis report significant negative impact across many areas of their life. We aimed to use an online survey using the EndoCost tool to determine if there was any difference in the impact of CPP in those with vs. those without a confirmed diagnosis of endometriosis, and if there was any change in diagnostic delay since the introduction of clinical guidelines in 2005. 409 responses were received; 340 with a diagnosis of endometriosis and 69 with no diagnosis. People with CPP, regardless of diagnosis, reported moderate to severe dysmenorrhea and non-cyclical pelvic pain. Dyspareunia was also common. Significant negative impact was reported for social, academic, and sexual/romantic relationships in both cohorts. In the endometriosis cohort there was a mean diagnostic delay of eight years, however there was a reduction in both the diagnostic delay (p < 0.001) and number of doctors seen before diagnosis (p < 0.001) in those presenting more recently. Both endometriosis and CPP have significant negative impact. Whilst there is a decrease in the time to diagnosis, there is an urgent need for improved treatment options and support for women with the disease once the diagnosis is made.

scholarly journals Endometriosis is an important cause of pelvic pain in adolescence

2014 ◽  
Vol 60 (6) ◽  
pp. 560-564 ◽  
Author(s):  
Marina de Paula Andres ◽  
Sergio Podgaec ◽  
Karina Belickas Carreiro ◽  
Edmund Chada Baracat
Keyword(s):  
Differential Diagnosis ◽  
Pelvic Pain ◽  
Clinical Characteristics ◽  
Chronic Pelvic Pain ◽  
Conventional Treatment ◽  
Tertiary Hospital ◽  
Ovarian Cysts ◽  
Common Disease ◽  
Important Differential Diagnosis ◽  
The University

Objective: despite endometriosis being a common disease, where early detection is key to preventing its progression, it is a condition often overlooked in adolescents. The aim of this study was to report the clinical characteristics of adolescent patients with endometriosis monitored in a tertiary hospital. Methods: a retrospective study of 394 patients undergoing surgery with a histological diagnosis of endometriosis at the Endometriosis Division of the Gynecology Department at the Hospital das Clínicas of the University of São Paulo Medical School from 2008 to 2013. 21 adolescents were included (aged under 21 years). Results: the age ranged from 17.95 ± 1.48 years, the average time for diagnostic confirmation was 2.96 ± 2.93 years, and the age at the onset of symptoms was 15.28 ± 3.03 years on average. The sites affected were ovarian (38%), peritoneal (47.6%) and retrocervical (23.8%). Dysmenorrhea was found in 80.9 % of adolescents (severe in 33.3% of cases) and chronic pelvic pain in 66.6%. Conclusion: endometriosis in adolescents is an important differential diagnosis from pelvic pain and ovarian cysts, mainly among those with no response to conventional treatment. The main forms of involvement are peritoneal and ovarian. Despite the onset of symptoms in adolescence and advances in imaging methods, the diagnosis of this disease is still delayed.

Differential diagnosis of chronic pelvic pain in women: the urologist's approach

2009 ◽  
Vol 6 (10) ◽  
pp. 557-562 ◽  
Author(s):  
Sophie G. Fletcher ◽  
Philippe E. Zimmern
Keyword(s):  
Differential Diagnosis ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain

Negative laparoscopy unveiled

2018 ◽  
Vol 10 (1) ◽  
pp. 18-21 ◽  
Author(s):  
John Jarrell ◽  
Lars Arendt-Nielsen
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Visceral Pain ◽  
Clinic Visit ◽  
Observer Error ◽  
Acute Pelvic Pain ◽  
Pain Sensitization ◽  
Student’S T ◽  
Nociceptive Input ◽  
Pain Testing

Introduction: Studies indicate a variable proportion of laparoscopies done for the management of non-acute pelvic pain that do not identify visible pathology and are called negative laparoscopies. Possible explanations have included undetected endometriosis, observer error, and/or neural tissues in the endometrium acting as nociceptive input. The goal was to compare demographic and pain testing measures between women with negative laparoscopies and confirmed endometriosis in a cohort of women presenting with chronic pelvic pain. Methods: Women with chronic pelvic pain (n = 255) provided written consent for the study prior to entry. Data were collected at the time of clinic visit and entered contemporaneously into SPSS. Pain sensitization was identified as the presence of cutaneous allodynia. Clinical, pain, and pain sensitization variables were compared using Student’s t-test. Results: The frequency of negative laparoscopy was 13.7% (35 cases) and that of confirmed endometriosis was 27.1% (69 cases). There were no differences between women with a negative laparoscopy and women with confirmed endometriosis in clinical, dysmenorrhea, or pain testing measurements. Conclusion: The data suggest in the absence of endometriotic tissue in the pelvis, chronic visceral pain may result from a uterine origin and result in a generalized pattern of pain and pain sensitization.

scholarly journals Endometriosis And Chronic Pelvic Pain Have Similar Impact On Women, But Time To Diagnosis Is Decreasing: An Australian Survey

2020 ◽  
Author(s):  
Mike Armour ◽  
Justin Sinclair ◽  
Cecilia H M Ng ◽  
Mikayla S Hyman ◽  
Kenny Lawson ◽  
...  
Keyword(s):  
Romantic Relationships ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Online Survey ◽  
Negative Impact ◽  
Treatment Options ◽  
Diagnostic Delay ◽  
Time To Diagnosis ◽  
Significant Negative Impact ◽  
The Impact

AbstractChronic pelvic pain (CPP) affects a significant number of women worldwide. Internationally, people with endometriosis report significant negative impact across many areas of their life. We aimed to use an online survey using the EndoCost tool to determine if there was any difference in the impact of CPP in those with vs. those without a confirmed diagnosis of endometriosis, and if there was any change in diagnostic delay since the introduction of clinical guidelines in 2005. 409 responses were received; 340 with a diagnosis of endometriosis and 69 with no diagnosis. People with CPP, regardless of diagnosis, reported moderate to severe dysmenorrhea and non-cyclical pelvic pain. Dyspareunia was also common. Significant negative impact was reported for social, academic, and sexual/romantic relationships in both cohorts. In the endometriosis cohort there was a mean diagnostic delay of eight years, however there was a reduction in both the diagnostic delay (p<0.001) and number of doctors seen before diagnosis (p<0.001) in those presenting more recently. Both endometriosis and CPP have significant negative impact. Whilst there is a decrease in the time to diagnosis, there is an urgent need for improved treatment options and support for women with the disease once the diagnosis is made.

scholarly journals Pelvic congestion syndrome: historical aspects and a modern view on the problem (a literature review)

2021 ◽  
Vol 23 (5) ◽  
pp. 723-729
Author(s):  
A. O. Nykonenko ◽  
B. S. Havrylenko
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Clinical Manifestations ◽  
Diagnostic Algorithm ◽  
Venous Stasis ◽  
Difficult Patient ◽  
Pelvic Congestion Syndrome ◽  
Detailed Medical History ◽  
Varicose Disease ◽  
Pelvic Congestion

Pelvic congestion syndrome is a relatively recent, but actual and separate nosological form. Pelvic varicocele is a form of varicose disease, which is increasingly regarded as the main cause of chronic pelvic pain in women with various clinical manifestations. A woman with chronic pelvic pain is a difficult patient with combative behavior, who contacts with physicians in various specialties. There are many causes of chronic pelvic pain, but pelvic congestion syndrome has a special place. In recent years, in addition to widespread use of diagnostic radiology, the relevance of this pathology is beyond any doubt. The aim of the study was to summarize and present literature data on the etiology, pathogenesis, clinical manifestations, diagnosis and treatment of pelvic congestion syndrome by analyzing the literature data. Materials and methods. A non-systematic review was conducted using PubMed, Web of Science, Google and Google Scholar databases. The review included free full-text articles published between 1974 and 2021 using key words: pelvic congestion syndrome, pelvic varices, pelvic venous disorders, pelvic varicocele, pelvic venous stasis, chronic pelvic pain, gonadal veins, ovarian veins, vena ovarica, Nutcracker syndrome, May–Thurner syndrome. Conclusions. Pelvic congestion syndrome is still a rarely diagnosed pathology in patients with chronic pelvic pain. Detailed medical history, physical examination as well as maintaining diagnostic algorithm would allow the disease to be diagnosed correctly and timely. The choice of method for surgical intervention is a key point in the treatment of patients with pelvic congestion syndrome, but today there are no criteria for the choice of one, so the problem is far from being resolved and requires further study and research.

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