Delavierre D, Rigaud J, Sibert L, Labat J-J
Service d'urologie-andrologie, centre hospitalier régional La-Source, 45067 Orléans cedex 2, France.
Prog Urol. 2010 Nov;20(12):853-64. doi: 10.1016/j.purol.2010.08.070. Epub 2010 Oct 12.
To review the definitions and classifications of chronic pelvic and perineal pain and to describe the concepts of chronic pelvic and perineal pain syndrome and the global diagnostic and aetiopathogenic approach.
A review of the literature was performed by searching the Medline database (National Library of Medicine). Search terms were either medical subject heading (MeSH) keywords (classification, complex regional pain syndrome, fibromyalgia, myofascial pain syndrome, neuralgia, pelvic pain, postoperative pain, prostatitis, referred pain, syndrome) or terms derived from the title or abstract. Search terms were used alone or in combinations by using the "AND" operator. The literature search was conducted from 1990 to the present time.
Chronic pelvic and perineal pain does not only consist of symptoms localized to an anatomical region present for 3 to 6 months, but also constitutes a distinct, complex, multidimensional disease entity, comprising psychological, organic and psychosomatic phenomena, called chronic pelvic and perineal pain syndromes. These syndromes are responsible for disability, impaired quality of life, and induce considerable health care consumption and sick leave. They alter the patient's personality and affect his or her behaviour, sex life, family life, social life and work life. The usual clinical approach to these syndromes, looking for an organ or tissue disease responsible for pain, is negative. The approach to this type of pain must be much more global and consists of looking for disturbances of the regulation of pelvic and perineal nociceptive messages and dysfunction of the organ or structure concerned.
The current definitions and classifications of chronic pelvic and perineal pain comprise the concepts of syndrome, functional disease and global approach and differ from the strict organ-based context and the classical medical approach (infectious, inflammatory, metabolic, endocrine) in order to focus pain syndromes on the pain itself and the associated symptoms.
回顾慢性盆腔和会阴疼痛的定义与分类，描述慢性盆腔和会阴疼痛综合征的概念以及整体诊断和病因学方法。
通过检索医学文献数据库（美国国立医学图书馆）进行文献综述。检索词为医学主题词（MeSH）关键词（分类、复杂性区域疼痛综合征、纤维肌痛、肌筋膜疼痛综合征、神经痛、盆腔疼痛、术后疼痛、前列腺炎、牵涉痛、综合征）或从标题或摘要中提取的术语。检索词单独使用或通过“AND”运算符组合使用。文献检索时间范围为1990年至今。
慢性盆腔和会阴疼痛不仅包括局限于某个解剖区域且持续3至6个月的症状，还构成一种独特、复杂、多维度的疾病实体，包括心理、器质性和身心现象，称为慢性盆腔和会阴疼痛综合征。这些综合征会导致残疾、生活质量受损，并引发大量医疗保健消耗和病假。它们会改变患者的性格，影响其行为、性生活、家庭生活、社交生活和工作生活。针对这些综合征的常规临床方法，即寻找导致疼痛的器官或组织疾病，结果为阴性。对于这类疼痛的处理方法必须更加全面，包括寻找盆腔和会阴伤害性信息调节的紊乱以及相关器官或结构的功能障碍。
慢性盆腔和会阴疼痛的当前定义和分类包含综合征、功能性疾病和整体方法的概念，与严格基于器官的背景和经典医学方法（感染性、炎症性、代谢性、内分泌性）不同，以便将疼痛综合征聚焦于疼痛本身及相关症状。
