The fundamentals of chronic pelvic pain assessment, based on international continence society recommendations

• Published in: Neurourology and urodynamics 2018-08, Vol.37 (S6), p.S32-S38
• Main Authors: Rana, Neha, Drake, Marcus J., Rinko, Rebecca, Dawson, Melissa, Whitmore, Kristene E.
• Format: Article
• Language: English
• Subjects: Chronic pain; chronic pelvic pain; Hysterectomy; lower urinary tract dysfunction; LUTS; Pain; pelvic floor muscle pain; Pelvis; Quality of life; Standardization; Terminology; Urinary tract
• ISSN: 0733-2467; 1520-6777
• DOI: 10.1002/nau.23776

Aims Chronic pelvic pain (CPP) is defined as a noncyclical pain that has duration of at least 6 months and can lead to decreased quality of life and physical performance. The pain can be attributed to problems in the pelvic organs and/or problems in related systems, and possible psycho‐social attributes may contribute to the manifestation. Due to the complex nature, CPP syndromes are multifactorial and the terminology needs to reflect the setting. Methods The current review is a synthesis of key aspects of the recent International Continence Society Standardization for Terminology in CPP Syndromes. Results Nine domains can be used for a detailed description of CPP. They include four domains specific to the pelvic organs (lower urinary tract, female genital, male genital, gastrointestinal), two related to other sources of pain which may be perceived in the pelvis (musculoskeletal, neurological) and three which may influence the response to the pain or its impact on the individual (psychological, sexual, and comorbidities). For an individual patient with CPP, each domain should be reviewed in terms of symptoms and signs, noting that positive findings could reflect either a primary cause or a secondary consequence. The findings will guide further evaluations and subsequent treatment. Conclusion We present a synthesis of the standard for terminology in CPP syndromes in women and men, which serves as a systematic framework to consider possible sources of pain (pelvic organs or other sources) and the individual responses and impact.