The Curbsiders Internal Medicine Podcast

#311 Chronic Pelvic Pain

Dec 20, 2021
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INSIGHT

Updated Definition Of Chronic Pelvic Pain

  • Chronic pelvic pain is pain below the umbilicus lasting >6 months and often includes menstrual pain (dysmenorrhea).
  • The newer definition is flexible and allows clinician and patient input when symptoms cause major disability.
ADVICE

Use An Organ-System Framework

  • Organize your differential by organ systems (bladder, bowel, musculoskeletal, reproductive, neurologic) instead of listing many diagnoses.
  • Screen which organ systems have symptoms to target testing and treatment efficiently.
INSIGHT

Expect Multiple Concurrent Causes

  • Many patients (20–40%) have more than one contributing cause for pelvic pain.
  • Expect overlapping diagnoses (eg, endometriosis + bladder pain + IBS) rather than a single cause.
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