gynaecology,pelvic pain,chronic pelvic pain

1. ANDREA

2.  Definition
 Noncyclic pain of 6 months duration or more
localised to the pelvis, anterior abdominal
wall ,below the pelvis, lower back; severe
enough to cause functional disability that
requires medical or surgical treatment.

3.  Endometriosis,Adenomyosis
 Uterine prolapse
 Retroversion of uterus
 Fibroid
 Ovarian cyst
 Pelvic adhesions secondary to PID, surgery or
endometriosis
 Trapped or residual ovarian syndrome
 Idiopathic

4.  Inter menstrual pain
 Dysmenorrhea
 Pre menstrual syndrome
 Pelvic congestion syndrome
 Endometriosis
 Adenomyosis
 Ovarian remnant syndrome

5. Gastrointestinal
Urological
Orthopaedic
Neurological
Hernias
Irritable bowel syndrome
Appendicitis
Constipation
Diverticulitis
Interstitial cystitis
Calculi
Urethral syndrome
Bones, ligaments, muscles
Nerve entrapment, compression
Inguinal, femoral

6.  Nerve entrapment pain
 Pessary test
 TENS
 Cognitive behavioural therapy
 IUD- Ectopic pregnancy
 Non gynaecological disorders
 CPP without organic lesion

7.  Blood
 Cervical & vaginal discharge
 Endometrial biopsy
 TVS
 CDS
 Laparoscopy
 X-ray

8.  Multidisciplinary approach
 Detectable pathology- removal of offending
pathology
 Medical line- NSAIDS,TCA, SSRI, Narcotics,
OCP, Danazol,
 Surgical- LUNA, PSN
HYSTERECTOMY

9. THANKYOU