Chronic pelvic pain (CPP) is one that is located at the level of the lower abdomen, the pelvis or intrapelvic structures, persisting for at least six months, which occurs continuously or intermittently.
If it is not acute and the mechanisms of central pain sensitization are well documented, pain is understood as chronic regardless of the elapsed time. In all cases, it is frequently associated with negative consequences in the cognitive, behavioral, sexual and emotional areas.
Chronic pelvic pain is a complex condition in which symptoms of the reproductive, urological, gastrointestinal, abdominal wall, pelvic floor, and psycho-social factors are frequently intermingled, so an exhaustive clinical history becomes very important.
Multidisciplinary Management of Pain
CPP is a symptomatic complex that can originate from gastrointestinal, urological, reproductive, musculoskeletal or neurological diseases. When the cause of the pain is evident, the treatment is directed to treat it. However, a subgroup of patients persists with pain despite treatment of the underlying cause. It is in this context that the multidisciplinary management of CPP, with the planned and interactive participation of different specialists (urologist, gynecologist, gastroenterologist, coloproctologist, pain specialist, psychiatrist, psychologist, kinesiology among others) is very important in both the study and treatment.
Multimodal therapy is redirected to treat the pain and the underlying cause -if it exists- and all those biological, psychological and environmental factors that are influencing.
A proper therapy of this condition includes medical treatment (non-steroidal anti-inflammatory drugs, opioids, antidepressants, neuromodulators, muscle relaxants, alpha blockers), but also psychotherapy, non-pharmacological therapy of the pelvic floor (biofeedback, myofascial massage), pelvic floor pharmacological therapy (injections in points trigger, botulinum toxin), bladder instillations, neuromodulation and surgical interventions (adhesiolysis, uterine neuroablation, presacral neurectomy) when appropriate.
At The Harley Street Hospital, we have the best specialists who can help you to treat chronic pelvic pain effectively. Book a consultation.