Baranowski Andrew Paul
The Centre for Urogenital Pain Medicine, University College London Hospitals Foundation Trust, The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK.
Best Pract Res Clin Gastroenterol. 2009;23(4):593-610. doi: 10.1016/j.bpg.2009.04.013.
Chronic pelvic pain affects both men and women; there are probably common mechanisms that involve the central nervous system. In many cases, the symptoms may be localised to a single end organ. However, the involvement of the central nervous system may result in a complex regional pain syndrome affecting the whole pelvis and as a consequence, multiple-organ symptomatology. The initial trigger may be relatively benign but a predisposed individual may develop a range of significant sensory and efferent functional abnormalities. Stimuli not normally reaching threshold may be perceived and normal sensations may be magnified to become dysphoric or painful. Problems of emptying viscera and maintaining continence may occur. Significant musculoskeletal disability may arise as well as abnormalities of the autonomic nervous system. There is an association with systemic disorders. Also, psychological, behavioural, sexual and social problems arise. In the chronic pelvic pain syndromes, treatment of the end organ has a limited role, and multidisciplinary as well as interdisciplinary management is essential.
慢性盆腔疼痛在男性和女性中均有发生；可能存在涉及中枢神经系统的共同机制。在许多情况下，症状可能局限于单一终末器官。然而，中枢神经系统的受累可能导致影响整个骨盆的复杂区域疼痛综合征，进而出现多器官症状。最初的触发因素可能相对良性，但易感个体可能会出现一系列明显的感觉和传出功能异常。通常未达到阈值的刺激可能会被感知，正常感觉可能会被放大而变得烦躁不安或疼痛。可能会出现内脏排空和维持控尿方面的问题。还可能出现严重的肌肉骨骼残疾以及自主神经系统异常。它与全身性疾病有关。此外，还会出现心理、行为、性和社会问题。在慢性盆腔疼痛综合征中，对终末器官的治疗作用有限，多学科以及跨学科管理至关重要。
