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Chronic Pelvic Pain


hronic pelvic pain (CPP) is one that is located at the level of the lower abdomen, the pelvis, or intrapelvic structures, persisting for at least six months, which occurs continuously or intermittently.

If it is not acute and the mechanisms of central pain sensitization are well documented, pain is understood as chronic regardless of the elapsed time. In all cases, it is frequently associated with negative consequences in the cognitive, behavioral, sexual, and emotional areas.

Chronic pelvic pain is a complex condition in which symptoms of the reproductive, urological, gastrointestinal, abdominal wall, pelvic floor, and psycho-social factors are frequently intermingled, so an exhaustive clinical history becomes very important.

Multidisciplinary Management of Pain

CPP is a symptomatic complex that can originate from gastrointestinal, urological, reproductive, musculoskeletal, or neurological diseases. When the cause of the pain is evident, the treatment is directed to treat it. However, a subgroup of patients persists with pain despite treatment of the underlying cause.  It is in this context that the multidisciplinary management of CPP, with the planned and interactive participation of different specialists (urologist, gynecologist, gastroenterologist, coloproctologist, pain specialist, psychiatrist, psychologist, kinesiology among others) is very important in both the study and treatment.

Multimodal therapy is redirected to treat the pain and the underlying cause -if it exists- and all those biological, psychological, and environmental factors that are influencing it.

A proper therapy for this condition includes medical treatment (non-steroidal anti-inflammatory drugs, opioids, antidepressants, neuromodulators, muscle relaxants, alpha-blockers), but also psychotherapy, non-pharmacological therapy of the pelvic floor (biofeedback, myofascial massage), pelvic floor pharmacological therapy (injections in points trigger, botulinum toxin), bladder instillations, neuromodulation and surgical interventions (adhesiolysis, uterine neuroablation, presacral neurectomy) when appropriate.

At The Harley Street Hospital, we have the best specialists who can help you to treat chronic pelvic pain effectively. Book a consultation.

Frequently Asked Questions

Chronic pelvic pain can be caused by various factors, including pelvic inflammatory disease, endometriosis, interstitial cystitis, pelvic floor dysfunction, or nerve disorders, making diagnosis and treatment complex and multifaceted.

Chronic pelvic pain is often managed rather than cured, with treatment focusing on alleviating symptoms and improving quality of life through a combination of therapies tailored to address underlying causes, such as medications, physical therapy, lifestyle modifications, and psychological support.

Non-gynecological pelvic pain refers to pain experienced in the pelvic region that is not directly related to the reproductive organs, often stemming from conditions such as gastrointestinal disorders, musculoskeletal issues, urinary tract problems, or nerve dysfunction, requiring a comprehensive evaluation to identify the underlying cause and appropriate management.