| April 2007 · Vol. 19, No. 04 UPDATE
NEW DEVELOPMENTS THAT ARE CHANGING PATIENT CARE
CHRONIC PELVIC PAIN
This complex disorder can involve multiple systems and require treatment on several fronts
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Fast Track
Multiple studies have reported success rates of 85–95% for vestibuloplasty
The LNG-IUS relieved endometriosis-related pain as effectively as depot leuprolide
Suboptimal response to generally effective treatments suggests myofascial factors may be contributing to pelvic pain
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John
F.
Steege,
MDProfessor of Obstetrics and Gynecology, Director, Division of Advanced Laparoscopy and Pelvic Pain, University of North Carolina, Chapel Hill
For many decades, chronic pelvic pain has been discussed, investigated, and treated as if it were caused by 1) a disorder of one of the visceral organ systems in the pelvis (gastrointestinal, urologic, or reproductive), or of somatic structures (pelvic floor muscles, etc) or 2) psychological dysfunction (depression, past abuse, personality disorder, anxiety, sexual dysfunction, and so on). Now, these assumptions are beginning to change.
Thanks to recent clinical investigation and experience, we are gaining a more complex understanding of the interactions among organ systems and the interplay between visceral and somatic structures and their contributions to pain. Understanding the interactions among these components should lead to more informed therapeutic approaches.
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