Pelvic Pain

Question 1

What is interstitial cystitis? What are symptoms?

Answer 1

Chronic inflammatory condition of bladder characterized by recurrent urinary urgency and frequency, in absence of evidence of another disease

Can cause pelvic pain or dyspareunia

Question 2

What are the Rome II Criteria for IBS diagnosis?

Answer 2

> =2/3 of:
Relief with defecation
Onset associated with change in stool frequency
Onset associated with change in stool form/appearance

Question 3

What percentage of women with chronic pelvic pain have history of abuse?

Answer 3

40-50%

Question 4

What nerves are at risk with a low transverse incision?

Answer 4

Iliohypogastric - cutaneous sensation to groin and skin overlying pubis
Ilioinguinal - cutaneous sensation to groin, symphysis, labium, and upper inner thigh
Both course medially between the internal and external oblique muscles

Question 5

What is suggested by pain that is constant, refractory to hormonal manipulation, and reproducible with palpation of somatic structures?

Answer 5

Neuromuscular pain or fibromyalgia

Treat with physical therapy/exercise, gabapentin or pregabalin (GABAergic medication)