Chronic pelvic pain: how many surgeries are enough?

The key to treatment of chronic pelvic pain is to treat it as the complex disease it is. Evidence is reviewed showing that identifying one aspect of the disease such as endometriosis or adhesions then treating only that component is not likely to be successful. Given our understanding of the neuropathology of chronic pelvic pain this failure of traditional therapy is to be expected. This evidence is reviewed and supports that an integrated treatment approach holds the most promise for a successful outcome. The goal of chronic pelvic pain management is for the clinician to identify every pain generator and treat each one.