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Treatment of patients with chronic pelvic pain is assisted by detailed history, physical examination, pain diary, and ultrasonography. The possibility of other contributing systems (eg, gastrointestinal, genitourinary, musculoskeletal) should also be addressed and treatment initiated if present. A diagnostic surgical procedure is helpful in patients for whom medical management or whose severity of pain warrants an urgent diagnosis. Limited evidence exists to support adhesions, endometriosis, ovarian cysts, ovarian remnants, and hernias as being causes of chronic pelvic pain. In select patients, ovarian cystectomy, excision of endometriosis and ovarian remnants, adhesiolysis, hysterectomy, hernia repair, and presacral neurectomy may provide relief.

作者:M Brigid, Holloran-Schwartz

来源:Obstetrics and gynecology clinics of North America 2014 年 41卷 3期

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作者:
M Brigid, Holloran-Schwartz
来源:
Obstetrics and gynecology clinics of North America 2014 年 41卷 3期
标签:
Adhesions and chronic pain Conscious laparoscopic pain mapping Diagnostic laparoscopy and chronic pelvic pain Hysterectomy and chronic pain Laparoscopic uterine nerve ablation Presacral neurectomy
Treatment of patients with chronic pelvic pain is assisted by detailed history, physical examination, pain diary, and ultrasonography. The possibility of other contributing systems (eg, gastrointestinal, genitourinary, musculoskeletal) should also be addressed and treatment initiated if present. A diagnostic surgical procedure is helpful in patients for whom medical management or whose severity of pain warrants an urgent diagnosis. Limited evidence exists to support adhesions, endometriosis, ovarian cysts, ovarian remnants, and hernias as being causes of chronic pelvic pain. In select patients, ovarian cystectomy, excision of endometriosis and ovarian remnants, adhesiolysis, hysterectomy, hernia repair, and presacral neurectomy may provide relief.