Gunter Jennifer
Department of Obstetrics and Gynecology, The University of Colorado Health Sciences Center, 4200 East 9th Avenue, Denver, Colorado 80262, USA.
Obstet Gynecol Surv. 2003 Sep;58(9):615-23. doi: 10.1097/01.OGX.0000083225.90017.01.
Chronic pelvic pain affects upward of 15% of women and is a frustrating condition for both patients and physicians. Chronic pelvic pain is not a disease, but a syndrome that results from a complex interaction between neurologic, musculoskeletal, and endocrine systems that is further influenced by behavioral and psychologic factors. Traditional approaches to this disorder have been surgical, although long-term success rates have been disappointing. Placebo response to surgery is common, and many conditions that contribute to the pain cannot be identified or treated with a surgical approach. Many patients will require a combination of both pharmacologic and nonpharmacologic treatments in addition to various types of invasive procedures. It is now recognized that many disorders contribute to the chronic pelvic pain symptom complex; thus, an integrated multidisciplinary approach to diagnosis and treatment is essential to achieve the greatest success.
Obstetricians & Gynecologists, Family Physicians.
After completion of this article, the reader will be able to describe the pathophysiology of chronic pelvic pain, to outline the evaluation of a patient with chronic pelvic pain, and to explain the treatment options for patients with chronic pelvic pain.
慢性盆腔疼痛影响着超过15%的女性，对患者和医生来说都是一种令人沮丧的病症。慢性盆腔疼痛并非一种疾病，而是一种综合征，它由神经、肌肉骨骼和内分泌系统之间复杂的相互作用导致，行为和心理因素会进一步对其产生影响。针对这种病症的传统治疗方法是手术，但长期成功率一直令人失望。手术的安慰剂反应很常见，而且许多导致疼痛的病症无法通过手术方法识别或治疗。除了各种侵入性手术外，许多患者还需要药物和非药物治疗相结合。现在人们认识到，许多病症都会导致慢性盆腔疼痛症状复合体；因此，采用综合多学科方法进行诊断和治疗对于取得最大成功至关重要。
妇产科医生、家庭医生。
读完本文后，读者将能够描述慢性盆腔疼痛的病理生理学，概述慢性盆腔疼痛患者的评估方法，并解释慢性盆腔疼痛患者的治疗选择。
