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Chronic Pelvic Pain Syndrome
Chronic Pelvic Pain

Presentation

EVIDENCE SYNTHESIS: Twenty-eight RCTs identified were eligible for this review and presented. [ncbi.nlm.nih.gov]

Entire Body System

  • Severe Pain

    CONCLUSION: Although fewer severe pain attacks occurred in summer, the mean NIH-CPSI scores did not differ across seasons. The pain from CP/CPPS had a greater impact on QoL during winter than it did in the other seasons. [ncbi.nlm.nih.gov]

    Sometimes the tissues that are found inside of a hernia have a decreased blood supply and cause severe pain. [medicinenet.com]

    If left untreated, PID can cause serious complications, including chronic, severe pain in the pelvis or abdomen. [healthline.com]

    For men, pelvic pain—that which is centered around the lower abdomen or buttocks—can be a sign of several different conditions. [verywellhealth.com]

  • Chills

    Patients with this condition: Have an acute urinary tract infection, and have to urinate more often (including at night); Have pain in the pelvis and genital area; Often have fever, chills, nausea, vomiting, and burning when urinating. [my.clevelandclinic.org]

    Other symptoms include: a burning sensation while urinating needing to urinate frequently changes in the color or smell of urine fever or chills pain in other areas, such as the sides or lower back A doctor will treat a UTI with a round of antibiotics [medicalnewstoday.com]

    Listed are the most common signs and symptoms of PID: Abnormal vaginal discharge Pain in the lower abdomen (often a mild ache) Pain in the upper right abdomen Abnormal menstrual bleeding Fever and chills Painful urination Nausea and vomiting Painful sexual [m.acog.org]

    Definition Symptoms Comments Type I (acute bacterial prostatitis) Acute infection of the prostate, identified by an increased white blood cell count and bacteria in urine that can be cultured in the laboratory (grown in sufficient quantities to be studied) Chills [health.harvard.edu]

  • Rigor

    We distinguished three levels of sensitivity and rigor of definition: CPCRN criteria, NIH criteria and “unclear”. [journals.plos.org]

    The interventions will be performed based on rigorous adherence to the standardized operating procedure. [trialsjournal.biomedcentral.com]

    Panel members' potential conflicts of interest are subject to rigorous and ongoing review during the development of the original Guideline and amendment Panel members are screened for conflicts throughout the amendment process. [auanet.org]

Gastrointestinal

  • Abdominal Pain

    The condition causes constipation, vomiting, abdominal pain, abdominal swelling, loss of appetite, and an inability to have a bowel movement or pass gas. [onhealth.com]

    […] have severe pelvic pain and any of these symptoms of testicular torsion, seek immediate medical attention: swelling of a testicle, redness/darkening of the scrotum, abdominal pain, nausea/vomiting, frequent urination, or fever. [verywellhealth.com]

    Chronic somatic, myofacial, and neurogenic abdominal pelvic pain. Clin Obstet Gynecol 1990;33:145–53. ↵ Slocumb JC. Neurological factors in chronic pelvic pain: trigger points and the abdominal pelvic pain syndrome. [sti.bmj.com]

    Hernia occurs when the abdominal wall is weakened, and abdominal organs may protrude through the area of weakness. Sometimes the tissues that are found inside of a hernia have a decreased blood supply and cause severe pain. [medicinenet.com]

    The classic features include urinary urgency and frequency, nocturia, dyspareunia and pelvic or lower abdominal pain [49]. [oatext.com]

  • Diarrhea

    RESULTS: Flare experiences were common and varied widely in terms of UCPPS symptoms involved, concurrent nonpelvic symptoms (e.g., diarrhea), symptom intensity (mild to severe), duration (minutes to years), and frequency (daily to CONCLUSIONS: Given their [ncbi.nlm.nih.gov]

    Irritable bowel syndrome (IBS) is a condition that often causes abdominal or pelvic pain along with diarrhea, constipation, bloating, and gas. Broken bones of the pelvis. [medicinenet.com]

    Symptoms you may have: Diarrhea Constipation Incontinence Flatulence Bloating Pain relieved by a bowel movement Uterine Fibroids Fibroids are noncancerous tumors that grow in, and on, the wall of the uterus. [webmd.com]

    Symptoms associated with irritable bowel syndrome — bloating, constipation or diarrhea — can be a source of pelvic pain and pressure. Painful bladder syndrome (interstitial cystitis). [mayoclinic.org]

    IBS commonly causes symptoms along the intestinal tract, such as: painful cramps bloating diarrhea constipation mucus in the stool These symptoms tend to go away temporarily after a bowel movement. [medicalnewstoday.com]

  • Abdominal Cramps

    They’re often accompanied by: vaginal bleeding or bright red spotting abdominal cramps feelings of pain in the pelvis, abdomen, or lower back flow of fluid or tissue from the vagina If you think you’re having a miscarriage, call your doctor or go to an [healthline.com]

  • Dyschezia

    Interestingly, a phase II randomised controlled trial in Brazil showed that oral therapy with melatonin 10mg/d was more effective than placebo in improving daily pain, dysmenorrhea, dysuria, dyschezia and sleep in women with biopsy-proven endometriosis [oatext.com]

Musculoskeletal

  • Thigh Pain

    The symptoms were as follows: 320 cases of perineal pain, 291 of perianal pain, 340 of lower abdomen and groin area aches, 298 of penile pain, 251 of double inner thigh pain, 293 of urinary frequency, 233 of more-frequent nocturia, 121 of urine bifurcation [spandidos-publications.com]

Neurologic

  • Excitement

    Inhibition of FAAH is hypothesized to reduce the excitability of urinary tract afferents including nociceptors. [ncbi.nlm.nih.gov]

    Clearing the gland may accelerate the removal of pathogenic microorganisms and toxins, comparable to a debridement and drainage effect, promoting the abrogation of inflammation, improving gland duct drainage, reducing sympathetic excitability, relieving [spandidos-publications.com]

    […] tenderness.23 Abdominal and pelvic examinations (bimanual and speculum) help identify areas of focal tenderness, the presence of any abdominal, uterine or adnexal masses, prolapse of pelvic organs, evidence of tethering or fixation of the uterus, cervical excitation [bpac.org.nz]

  • Neuralgia

    Pudendal neuralgia can be managed with either conservative or surgical approaches (Table 3). [oatext.com]

    Pudendal Neuralgia The pudendal nerve is the nerve of the perineum, the area between the anus and vulva in women or the scrotum in men. Pudendal neuralgia is a pain syndrome that occurs when the pudendal nerve is irritated, damaged, or compressed. [onhealth.com]

    Pudendal neuralgia Pudendal neuralgia causes a burning or sharp pain in the ‘saddle’ area, anywhere from the clitoris back to the anal area, when sitting. [racgp.org.au]

    […] pain syndrome (interstitial cystitis), urethral pain syndrome Neuromuscular Trauma (e.g. secondary to vaginal delivery), surgery (e.g. any abdominal wall incision including caesarean section), pelvic floor muscle pain syndrome, vaginal muscle spasm, neuralgia [bpac.org.nz]

Urogenital

  • Dysuria

    Associated issues that signal that your pelvic pain could be caused by a serious issue include: Fever Frequent urination, particularly at night (nocturia) An urgent need to urinate Pain or burning sensation when urinating (dysuria) A bulge of the pelvis [verywellhealth.com]

    If the bladder is involved, patients may also complain of dysuria, hematuria and urinary frequency [31]. The pathophysiology of endometriosis remains unknown. [oatext.com]

    Early clinical symptoms may begin with mild dysuria or urinary urgency. Mild symptoms may progress to severe voiding frequency, nocturia, and suprapubic pain. [auanet.org]

    Urinary Tract Infection A urinary tract infection (UTI) may cause pelvic pain, but usually has associated painful urination (dysuria), frequent urge to urinate, and lower pelvic pressure. [onhealth.com]

    Leslie, MD, has found that some of his patients have very alkaline urine, which can also be irritating and result in discomfort and dysuria. Sitz bath Sitz baths may provide partial relief from acute exacerbations. [emedicine.medscape.com]

  • Dyspareunia

    The search terms used were “dyspareunia,” “dysmenorrhoea,” and “pelvic/abdominal pain.” [sti.bmj.com]

    The classic features include urinary urgency and frequency, nocturia, dyspareunia and pelvic or lower abdominal pain [49]. [oatext.com]

    Sexual history Pain on initial penetration suggests vulvodynia or vaginal/pelvic muscle spasm, deep dyspareunia is associated with endometriosis, while post-coital pain can be a feature of pelvic congestion syndrome. [bpac.org.nz]

    Pain During Sex Pelvic pain during sex (dyspareunia) has been discussed as a symptom in most of the conditions described previously. Pain may occur superficially on the surface of the genitals, deeper near the cervix, or anywhere in between. [onhealth.com]

  • Dysmenorrhea

    Henry Gray (1918) Anatomy of the Human Body Medscape Henry Gray (1918) Anatomy of the Human Body REFERENCES: The American College of Obstetricians and Gynecologists: "Dysmenorrhea: Painful Periods." [onhealth.com]

    The medical term for menstrual pain is dysmenorrhea. Many women experience mild menstrual pain, but for some women the pain is severe and disrupts their participation in day-to-day activities. [medicinenet.com]

    Pain during menstruation is called dysmenorrhea. This pain may feel like cramps in the abdomen, or like a nagging pain in the thighs and lower back. [healthline.com]

    Interestingly, a phase II randomised controlled trial in Brazil showed that oral therapy with melatonin 10mg/d was more effective than placebo in improving daily pain, dysmenorrhea, dysuria, dyschezia and sleep in women with biopsy-proven endometriosis [oatext.com]

  • Penile Pain

    For example, pressing on a trigger point in the muscles of the pelvic floor (puborectalis/pubococcygeus muscles) was found in the study to cause patients to experience penile pain. [34] A trigger point is a hyperirritable, sensitive, or tender spot within [emedicine.medscape.com]

    The symptoms were as follows: 320 cases of perineal pain, 291 of perianal pain, 340 of lower abdomen and groin area aches, 298 of penile pain, 251 of double inner thigh pain, 293 of urinary frequency, 233 of more-frequent nocturia, 121 of urine bifurcation [spandidos-publications.com]

Workup

In terms of that, we would evaluate any system that we feel is necessary, and that requires an additional workup to see the cause of Chronic Pelvic Pain Syndrome. [youtube.com]

This consideration may require additional diagnostic workup and/or referral to appropriate specialists. Treatment Levels for IC/BPS. [auanet.org]

X-Ray

  • Nephrolithiasis

    Medscape: "Chronic Pelvic Pain in Women," "Nephrolithiasis." NIH Eunice Kennedy Shriver National Institute of Child Health and Human Development: "Pelvic Pain." NIH Genetic and Rare Diseases Information Center: "Adenomyosis," "Pudendal Neuralgia." [onhealth.com]

Treatment

CONCLUSION: However the treatment of CP-CPPS is challenging and difficult for the urologists. This clinical study showed that the acupuncture treatment is a safe and effective treatment of category IIIB CP-CPPS. Copyright © 2015 Elsevier Inc. [ncbi.nlm.nih.gov]

Prognosis

What is the prognosis for a person with pelvic pain? The prognosis can be excellent for certain types of pelvic pain, such as an ectopic pregnancy that has not ruptured or an uncomplicated UTI. [medicinenet.com]

[…] absence of infection.[2] In 1999, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) devised a new classification system.[3][4] For more specifics about each type of prostatitis, including information on symptoms, treatment, and prognosis [en.wikipedia.org]

Inform the patient that none of these items is known to cause actual physical damage or to worsen the long-term prognosis. Nevertheless, responsible limitation of these items may help to control the day-to-day symptoms. [emedicine.medscape.com]

Turner JA, Ciol MA, Von Korff M, Berger R (2004) Prognosis of patients with new prostatitis/pelvic pain syndrome episodes. J Urol 172: 538–541. View Article Google Scholar 56. [journals.plos.org]

Etiology

PURPOSE: Although chronic prostatitis/chronic pelvic pain syndrome is a prevalent urological disorder among men of all ages, its etiology remains unknown. [ncbi.nlm.nih.gov]

Epidemiology

KEYWORDS: cystitis; epidemiologic research design; interstitial; pain; prostate; symptom assessment [ncbi.nlm.nih.gov]

Pathophysiology

With its multifactorial pathophysiology and its various clinical presentations, the management of CP/CPPS demands a phenotypic-directed approach addressing the individual clinical profile of each patient. [ncbi.nlm.nih.gov]

Prevention

Can chronic pelvic pain be prevented or avoided? Whether your chronic pelvic pain can be prevented or avoided depends on what is causing the pain. There are many different causes. Some of them can be prevented. Others cannot be prevented. [familydoctor.org]

UCPPS symptoms involved, concurrent nonpelvic symptoms (e.g., diarrhea), symptom intensity (mild to severe), duration (minutes to years), and frequency (daily to CONCLUSIONS: Given their negative impact, future research should focus on approaches to prevent [ncbi.nlm.nih.gov]

How can pelvic inflammatory disease be prevented? To help prevent PID, take the following steps to avoid STIs: Use condoms every time you have sex to prevent STIs. Use condoms even if you use other methods of birth control. [m.acog.org]

Can pelvic pain be prevented? Pelvic pain can only be prevented to the extent that the specific cause of pain can be prevented. [medicinenet.com]

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