Department of Endo-Gynecology, Royal Hospital for Women, Sydney, New South Wales, Australia.
Int J Womens Health. 2010 Aug 20;2:263-77. doi: 10.2147/IJWH.S7991.
This article reviews the literature on management of chronic cyclical pelvic pain (CCPP). Electronic resources including Medline, PubMed, CINAHL, The Cochrane Library, Current Contents, and EMBASE were searched using MeSH terms including all subheadings and keywords: "cyclical pelvic pain", "chronic pain", "dysmenorrheal", "nonmenstrual pelvic pain", and "endometriosis". There is a dearth of high-quality evidence for this common problem. Chronic pelvic pain affects 4%-25% of women of reproductive age. Dysmenorrhea of varying degree affects 60% of women. Endometriosis is the commonest pathologic cause of CCPP. Other gynecological causes are adenomyosis, uterine fibroids, and pelvic floor myalgia, although other systems disease such as irritable bowel syndrome or interstitial cystitis may be responsible. Management options range from simple to invasive, where simple medical treatment such as the combined oral contraceptive pill may be used as a first-line treatment prior to invasive management. This review outlines an approach to patients with CCPP through history, physical examination, and investigation to identify the cause(s) of the pain and its optimal management.
这篇文章回顾了慢性周期性盆腔痛（CCPP）的管理文献。使用 MeSH 术语（包括所有副标题和关键词），包括 Medline、PubMed、CINAHL、Cochrane 图书馆、Current Contents 和 EMBASE 等电子资源进行了搜索：“周期性盆腔痛”、“慢性疼痛”、“痛经”、“非经期盆腔痛”和“子宫内膜异位症”。对于这个常见问题，高质量的证据非常缺乏。慢性盆腔痛影响 4%-25%的育龄妇女。不同程度的痛经影响 60%的女性。子宫内膜异位症是 CCPP 最常见的病理原因。其他妇科原因包括子宫腺肌病、子宫肌瘤和盆底肌痛，尽管其他系统疾病，如肠易激综合征或间质性膀胱炎，也可能是病因。管理选项范围从简单到侵入性，简单的药物治疗，如复方口服避孕药，可在侵入性治疗前作为一线治疗。本文通过病史、体格检查和检查，概述了 CCPP 患者的治疗方法，以确定疼痛的原因及其最佳治疗方法。
