Chronic pelvic pain; more than just the bladder

Curr Opin Urol. 2024 Mar 1;34(2):69-76. doi: 10.1097/MOU.0000000000001134. Epub 2023 Oct 12.

Abstract

Purpose of review: Chronic pelvic pain is much of a burden to those who suffer from it. Additionally, in many patients medical doctors, such as urologists are unable to identify a cause or clear pathology that can explain the pain. Still numerous patients and doctors keep on searching for a cause, focussing particularly on the pelvic organs. Lots of diagnostics and treatment methods are used but often without success. In recent years, we have gained increased insight into the mechanisms of pain and adapted the terminology accordingly.

Recent findings: Two aspects of chronic pelvic pain have gained more attention. First, the myofascial aspects, especially the role of the pelvic floor muscles in maintaining the pain and as a therapeutic option. Second, the role of the brain and the psychological aspects intertwine with the pain and its consequences also open up for alternative management options. In terminology chronic pain is now included in the ICD-11, a historical change. Introducing chronic primary pain (no cause found) helps us to look away from the organ and deal with the patient as a whole human being.

Summary: The findings reported here are helpful for your daily practice. Looking from a broad perspective gives the patient the feeling of being seen and heard. Working together in a multidisciplinary team makes your work easier and gives more satisfaction.

Video abstract: http://links.lww.com/COU/A44.

Publication types

  • Review
  • Video-Audio Media

MeSH terms

  • Chronic Pain* / complications
  • Chronic Pain* / therapy
  • Humans
  • Myofascial Pain Syndromes* / complications
  • Myofascial Pain Syndromes* / therapy
  • Pelvic Pain / etiology
  • Pelvic Pain / psychology
  • Pelvic Pain / therapy
  • Pelvis
  • Urinary Bladder