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Query: UMLS:C0030794 (pelvic pain)
 4,056 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a debilitating condition, traditionally treated with antimicrobials, nonsteroidal anti-inflammatory drugs, and alpha-blockers. Pelvic floor tension myalgia is hypothesized to be a contributing factor in CPPS. Biofeedback training for CPPS is based on the principle that maximum muscle contraction prompts maximum muscle relaxation. Similar chronic pain conditions have been treated successfully with biofeedback-assisted techniques of neuromuscular reeducation. Preliminary study by our group has shown biofeedback, pelvic floor reeducation, and bladder training to be helpful in the treatment of CP/CPPS. Overall, 8 of 11 patients had improvement in either pain scores or their chronic prostatitis pain index scores. With no cure for CP/CPPS available, biofeedback and pelvic floor reeducation merit further evaluation in the treatment of this condition.
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PMID:Bladder training biofeedback and pelvic floor myalgia. 1252 95

Reflex sympathetic dystrophy (RSD) is a complex and poorly-understood condition characterized by: (a) pain and altered sensation; (b) motor disturbance and soft tissue change; (c) vasomotor and autonomic changes; and (d) psychosocial disturbance. Neurological symptoms typically do not conform to any particular pattern of nerve damage. Many different names have been ascribed to this condition and most recently the term 'complex regional pain syndrome' has been coined to emphasize the complex interaction of somatic, psychological and behavioural factors. Diagnostic criteria have been proposed by the International Association for the Study of Pain, but are still subject to debate. This review article describes the clinical features which may present as part of the condition, and the patho-physiology and pre-disposing factors so far identified. The evidence for effectiveness of different interventions is presented and a treatment approach outlined for inter-disciplinary management. While RSD is traditionally associated with pain in the extremities, the possibility is raised that the same process may underlie chronic pain syndromes affecting more central structures, such as testicular or pelvic pain.
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PMID:Reflex sympathetic dystrophy--a complex regional pain syndrome. 1252 47

Chronic pelvic pain is a common and significant disorder of women. It is estimated to have a prevalence of 3.8% in women. Often the etiology of chronic pelvic pain is not clear, as there are many disorders of the reproductive tract, gastrointestinal system, urological organs, musculoskeletal system, and psychoneurological system that may be associated with chronic pelvic pain. The history and physical examination are crucial in evaluating a woman with chronic pelvic pain and must address all of the possible systems potentially involved in chronic pelvic pain, not just the reproductive system. Laboratory and imaging studies should be selectively utilized, as should laparoscopy. Conscious laparoscopic pain mapping has been proposed as a way to improve information derived from laparoscopic evaluations. Treatment of chronic pelvic pain may consist of two approaches. One is to treat chronic pain itself as a diagnosis, and the other is to treat diseases or disorders that might be a cause of or a contributor to chronic pelvic pain. These two approaches are not mutually exclusive, and in many patients effective therapy is best achieved by using both approaches. Treatment of chronic pain as well as treatment of four of the more common disorders associated with chronic pelvic pain (endometriosis, adhesions, irritable bowel syndrome, and interstitial cystitis) are discussed in this review.
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PMID:Chronic pelvic pain. 1296 62

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), is of considerable interest in clinical urology. During the past decade, several new approaches have been made to discover its aetiology and pathophysiological mechanisms and to develop treatment modalities. The aetiology of CPPS has remained unresolved. Bacterial, chemical, urodynamic and immunological aetiologies have been suggested, but none of these has been conclusively proven. The histopathological changes in CP and CPPS are relatively well known, but the pathophysiological changes that lead to chronic inflammation and prolonged symptoms are still poorly understood. This review proposes an additional approach to the pathophysiology of CPPS. The concept of prostate tissue pressure is introduced as an objectively measurable parameter in evaluating the inflammatory process in CPPS. Chronic pain due to neurogenic inflammation and altered mast cell function is also discussed.
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PMID:Mechanisms of pain in chronic pelvic pain syndrome: influence of prostatic inflammation. 1270 Sep 22

The topic of chronic pelvic pain (CPP) has long been a frustrating one for physicians and patients alike, with difficulties in diagnosis and management leading to delays in recovery. Recent insights into the neurobiology of chronic pain disorders and into mechanisms of visceral pain suggest that significant advances in treatment of CPP are likely to occur during coming years. These insights suggest that we consider directing our treatment efforts away from the visceral organ presumed to be primarily responsible for the CPP and toward treatment of the neurologic mechanisms that sustain chronic pain.
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PMID:Chronic pelvic pain. 1284 58

Interstitial cystitis (IC) is a chronic pain syndrome that affects close to a million people in the United States. The syndrome presents differently in many individuals, with the unifying factor being chronic pelvic pain and disruption of daily life activities. Many etiologies have been proposed as causative factors for IC, although it is likely triggered by more than one process. Treatment for many individuals revolves around symptom management and improving quality of life; however, it is imperative to remove aggravating factors such as food and daily stressors. Treatment will vary for individuals, as symptoms and etiology will differ. This article discusses nutritional and other non-toxic approaches to treating IC.
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PMID:Interstitial cystitis: understanding the syndrome. 1465 69

Pain is one of the most common reasons that patients seek medical care, and affects one-third of the population within a given year. Pain is not always "functional" (physiologic), but often is pathologic, or chronic. This article describes the mechanisms of pain, showing how a protective response can become altered to chronic pain state, such as chronic pelvic pain.
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PMID:Neural mechanisms of pain. 1548 80

Although menopause is a normal developmental milestone through which all women pass, the transition has been long associated with chronic pain conditions that may be more accurately viewed as secondary to aging. Clinicians need to understand management of pain problems women may experience. This article examines pain syndromes including headache, back pain, osteoarthritis, pelvic pain, vulvo-vaginal pain, and burning mouth syndrome.
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PMID:Pain at midlife. 1554 82

Endometriosis is a disease defined by the presence of endometrial tissue outside of the uterus. Severe pelvic pain is often associated with endometriosis, and this pain can be diminished with therapies that suppress estrogen production. Many women with endometriosis also suffer from other chronic pain conditions. Recent studies suggest that mechanisms underlying these pains and sensitivity to estrogen involve the growth into the ectopic endometrial tissue of a nerve supply, which could have a varied and widespread influence on the activity of neurons throughout the central nervous system.
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PMID:The pains of endometriosis. 1594 76

The post partum pubic symphysis diastasis is an uncommon disease. It is resposible of acute pelvic pain. It increases when manual pressure is applied to the pelvis in a latero-lateral and antero-posterior direction. The diagnostic test for this condition is an anteroposterior X-ray of the pelvis. Here we present a case following spontaneous vaginal delivery. The conservative treatment is able to obtain good results. If this disease is underestimated the patient can develop chronic pain.
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PMID:Post partum diastasis of the pubic symphysis: a case report. 1611 27


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