Pierce Angela N, Christianson Julie A
Department of Anatomy and Cell Biology, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA.
Department of Anatomy and Cell Biology, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA.
Prog Mol Biol Transl Sci. 2015;131:509-35. doi: 10.1016/bs.pmbts.2014.11.009. Epub 2015 Feb 2.
Chronic pelvic pain is the number one reason that patients suffering from irritable bowel syndrome, interstitial cystitis/painful bladder syndrome, vulvodynia, or chronic prostatitis/chronic pelvic pain syndrome seek medical attention. These syndromes generally have no associated pathology or identified underlying etiology, although dysfunction within the immune system, central nervous system, and peripheral nervous system has been identified. Due to the lack of pathology, chronic pelvic pain syndromes are often diagnosed by exclusion, and the high degree of comorbid symptomology among these and other functional pain disorders complicate identifying appropriate treatment strategies. Chronic stress exposure early in life has been shown to increase the likelihood of pelvic pain later in life, and acute stress exposure can induce or increase symptom severity. In this chapter, we describe the individual chronic pelvic pain syndromes and how stress influences the likelihood of diagnosis and the severity of symptoms experienced by patients.
慢性盆腔疼痛是肠易激综合征、间质性膀胱炎/疼痛性膀胱综合征、外阴痛或慢性前列腺炎/慢性盆腔疼痛综合征患者就医的首要原因。这些综合征通常没有相关的病理学表现或明确的潜在病因，尽管已经确定免疫系统、中枢神经系统和周围神经系统存在功能障碍。由于缺乏病理学依据，慢性盆腔疼痛综合征通常通过排除法进行诊断，而且这些综合征与其他功能性疼痛障碍之间高度的共病症状使得确定合适的治疗策略变得复杂。早年长期暴露于应激状态已被证明会增加日后发生盆腔疼痛的可能性，而急性应激暴露可诱发或加重症状的严重程度。在本章中，我们将描述各种慢性盆腔疼痛综合征，以及应激如何影响诊断的可能性和患者所经历症状的严重程度。
