This document defines chronic pelvic pain as noncyclic pain lasting at least 6 months in the pelvis, lower abdomen, or lower back that causes functional disability requiring medical or surgical treatment. Potential causes of chronic pelvic pain include endometriosis, adenomyosis, uterine prolapse, fibroids, ovarian cysts, and pelvic adhesions. Symptoms may include intermenstrual pain, dysmenorrhea, premenstrual syndrome, and pelvic congestion syndrome. Diagnostic tests include blood tests, endometrial biopsy, transvaginal ultrasound, cystoscopy, and laparoscopy. Treatment involves a multidisciplinary approach including removing identifiable pathology, medications like NSAIDs, TCAs, and

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