True about chronic pelvic pain?
Chronic pelvic pain Defined as pelvic pain that persists in the same location for greater than 6 months duration, acusing functional debility or requiring treatment. Causes can be gynaecological or non-gynaecological Gynaecological causes: Endometriosis Pelvic adhesions Pelvic congestion syndrome Sub acutesalpingo-oophoritis Ovarian remnant syndrome Residual ovary syndromes Vulvodynia Non-gynaecological Irritable bowel syndrome Urethral syndrome Interstitial cystitis or painful bladder syndrome Nerve entrapment syndromes Myofascial pain Fibromyalgia Low back pain syndrome Psychological pain Any surgery done for adhesions may lead to formation of fuher adhesions and so adhesiolysis is recommended only for patients with intermittent paial bowel obstruction or infeility.
Pain in the same location in lower abdomen lasting 6 months or more
Causes are exclusively gynaecological
Adhesiolysis should be done for all patients with adhesions causing chronic pelvic pain
Does not cause functional debility and patients do not require treatment
Normal Menstruation, Abnormal Menstruation, Menopausal Physiology and forsight of conception