Medicine an Surgery notes

Apr 25th, 2015
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Chronic pelvic painDr. Mridula A. Benjamin.Dept of Obs and GynRIPAS Hospital, BruneiAn unpleasant sensory and emotionalexperience associated with actual orpotential tissue damageWhy is Chronic Pelvic Pain so Different?Difficult / UnsatisfactoryAcute pelvic pain: symptom of underlying tissue injury.Chronic pelvic pain: pain becomes the diseaseRecurrent, unrelated to menses, intercourse, pregnancyChronic pain: pain lasting 6 months or longer.Chronic pelvic pain syndrome: chronic pelvic paincausing emotional and behavioral changes.Type of painVisceral painReferred PainSomatic PainMyalgiaHyperalgesiaNeuroinflammationSources of chronic pelvic painGynecologicalUrologicalGastrointestinalMusculoskeletalNeuropathicOtherIncidence14 24% of women b/w 18 and 50 years.1/3 do not consult doctor.60% who consult are not referred to tertiarycentre.Population studies: GI (37%), Urinary (31%),Gynae (20%).Laparoscopic findings: No pathology (35%),Endometriosis (33%), Adhesions (24%).Differential Diagnosis forChronic Pelvic PainGynecologicGastrointestinalEndometriosis syndromeIrritable bowelAdhesions (chronic pelvicinflammatory disease)Chronic AppendicitisLeiomyomataInflammatory bowel diseaseAdenomyosisDiverticulosisPelvic congestion syndromeDiverticulitisMeckels diverticulumDifferential DiagnosisUrologicPsychol

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