Updates in the Approach to Chronic Pelvic Pain: What the Treating Gynecologist Should Know.

Abstract:

:Chronic pelvic is a multifaceted condition that often has both peripheral and central generators of pain. Despite its high prevalence, the evaluation and management of a pelvic pain patient often present many challenges to the practicing gynecologist. As with many other chronic pain conditions, pain severity does not always correlate with pelvic pathology and standard medical and surgical therapies are not always effective. An understanding of neurobiology and neuropsychology of chronic pelvic pain along with clinical pearls in the history and physical examination should guide management. Successful treatment of pelvic pain is typically multimodal, a combination of pharmacologic treatment strategies directed at the affected pathology and surrounding structures along with behavioral therapy. Evidence for these and other emerging therapies are presented in this article.

journal_name

Clin Obstet Gynecol

authors

Carey ET,Moore K

doi

10.1097/GRF.0000000000000486

subject

Has Abstract

pub_date

2019-12-01 00:00:00

pages

666-676

issue

4

eissn

0009-9201

issn

1532-5520

journal_volume

62

pub_type

杂志文章
  • Intrahepatic Cholestasis of Pregnancy.

    abstract::Intrahepatic cholestasis of pregnancy is a common disorder of pregnancy manifested by pruritus and elevated bile acids. The etiology of cholestasis is poorly understood and management is difficult due to the paucity of data regarding its diagnosis, treatment, and related adverse outcomes. In this article, we review th...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/GRF.0000000000000495

    authors: Smith DD,Rood KM

    更新日期:2020-03-01 00:00:00

  • Benign breast diseases: epidemiology, evaluation, and management.

    abstract::Benign breast diseases are common and encompass a spectrum of disorders. The majority of diagnoses will stem from a patient presenting with symptoms such as a mass or discomfort, or as a result of breast imaging which shows abnormalities leading to percutaneous biopsy. When mammographic and pathologic findings are dis...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/GRF.0b013e318208010e

    authors: Rungruang B,Kelley JL 3rd

    更新日期:2011-03-01 00:00:00

  • Failed Intrauterine Pregnancy: What Is a Failed Pregnancy, What Is Not?

    abstract::Pregnancy failure is defined as a lack of sonographic evidence of current or expected viability. Technologic advances in ultrasound imaging continue to redefine diagnostic criteria of pregnancy failure or success. When evaluating a pregnancy, the first step is an assessment of maternal risk factors for failure. Imagin...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/GRF.0000000000000301

    authors: Canavan TP

    更新日期:2017-09-01 00:00:00

  • A discussion of clinical decision support services.

    abstract::The software known as Clinical Decision Support Services (CDSS) has emerged as a buzzword from the explosion of information systems within health care. CDSS is installed within a practice to provide resources and tools to support the utilization of patient data in the provider decision-making process. Additional appli...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/GRF.0b013e31829cb0bf

    authors: Booker CC,Andrews PN

    更新日期:2013-09-01 00:00:00

  • Laparoscopic management of the adnexal mass.

    abstract::Ovarian neoplasms are common in women of all ages. As many as 10% of women in the United States will undergo surgical removal of an adnexal mass sometime in their lifetime. Gynecologic surgeons have pioneered laparoscopic surgery, developing what was originally a diagnostic tool into a safe and effective approach to m...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/00003081-200609000-00013

    authors: Hilger WS,Magrina JF,Magtibay PM

    更新日期:2006-09-01 00:00:00

  • Comparison of first and second trimester aneuploidy risk assessment.

    abstract::Counseling regarding the options for aneuploidy risk assessment is complicated and requires thorough counseling with the patient. Second trimester serum risk assessment has been the gold standard because of widespread availability, low cost, and vast experience with counseling and performance. First trimester risk ass...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0b013e31804c9b99

    authors: Reddy UM,Wapner RJ

    更新日期:2007-06-01 00:00:00

  • Antenatal Management of Placenta Accreta.

    abstract::Predelivery diagnosis of placenta accreta, increta, and percreta (from here referred to as placenta accreta, unless otherwise noted) has increasingly created opportunities to optimize antenatal management. Despite the increased frequency of placenta accreta today, occurring in as many as 1 in 533 to 1 in 272 deliverie...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0000000000000394

    authors: Haunschild C,Yeaton-Massey A,Lyell DJ

    更新日期:2018-12-01 00:00:00

  • Operative vaginal delivery: a cause of birth injury or is it?

    abstract::Operative vaginal delivery has been maligned since the days of W.J. Little with the word "forceps" becoming nearly synonymous with "Birth Injury" and "Cerebral Palsy." However in his presentation to the Obstetrical Society of London in 1861, Little's emphasis was on difficult labors being the culprit in subsequent dis...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0b013e31811eaa39

    authors: Towner DR,Ciotti MC

    更新日期:2007-09-01 00:00:00

  • Errors and analysis of errors.

    abstract::Methods of analyzing errors and proactively preventing errors are discussed. A framework for using these concepts is presented. ...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0b013e3181899a5a

    authors: Mulligan MA,Nechodom P

    更新日期:2008-12-01 00:00:00

  • The anesthesiologist's role during attempted VBAC.

    abstract::American College of Obstetricians and Gynecologists' guidelines on vaginal birth after cesarean had both intended and unintended consequences for anesthesiologists. Epidural analgesia continues to play an important role in patient acceptance of a trial of labor after prior cesarean delivery. It does not impact the suc...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/GRF.0b013e3182618937

    authors: Hawkins JL

    更新日期:2012-12-01 00:00:00

  • "How-To" Guide to Pelvic Floor Muscle Dysfunction.

    abstract::The purpose of this paper is to assist the clinician in recognizing pelvic floor muscle dysfunction in women with vulvar symptoms, to provide general treatment algorithms, and to facilitate understanding of the scientific rationale behind appropriate treatment. In short, this paper is meant to provide a "how-to" guide...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/GRF.0000000000000135

    authors: Albrecht KB

    更新日期:2015-09-01 00:00:00

  • Counseling in gynecologic practice: an overivew.

    abstract::We live in a turbulant period with regard to interpersonal relationships. Individuals place great emphasis on their ability to form good relationships. It is a time of desiring and searching; desiring to be engaged in a rewarding relationship and searching for any principles which might promote such involvement. Obste...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/00003081-197803000-00014

    authors: Burchell RC

    更新日期:1978-03-01 00:00:00

  • Induction of Labor and Cesarean: What is the True Relationship?

    abstract::It is a commonly held belief that labor induction increases the risk of cesarean delivery; women who are induced are at higher risk of cesarean as compared with those in spontaneous labor. This comparison group is inaccurate, however, as women and providers cannot choose spontaneous labor as the alternative to labor i...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0000000000000112

    authors: Little SE,Caughey AB

    更新日期:2015-06-01 00:00:00

  • Impact of antenatal and postpartum maternal mental illness: how are the children?

    abstract::Prospective studies that begin during pregnancy and follow the mothers and children into adolescence have shown that maternal mental illness during the antenatal and postpartum period can have long-lasting negative consequences on the developing child. The findings from these prospective studies and a discussion of th...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0b013e3181b52930

    authors: Brand SR,Brennan PA

    更新日期:2009-09-01 00:00:00

  • Current Management of the Axilla.

    abstract::Despite advances in estimating prognosis and predicting response to adjuvant systemic therapy, the status of the axillary lymph nodes remains a critical component in initial surgical planning and in determining therapeutic strategies for patients with breast cancer. Buoyed by evidence from multi-institutional randomiz...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0000000000000232

    authors: McCARTAN D,Gemignani ML

    更新日期:2016-12-01 00:00:00

  • Ambulatory obstetrical care: strategies to reduce telephone liability.

    abstract::The telephone will become the centerpiece of ambulatory care services. As such, a pertinent aspect of office procedures will necessarily include a protocol to manage and document telephone calls. Encourage your office staff to use good telephone manners, as listed in Table 5. The net result should be a reduction in te...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/00003081-199809000-00018

    authors: Phelan JP

    更新日期:1998-09-01 00:00:00

  • Laparoscopy.

    abstract::Laproscopic sterilization techniques and the diagnostic use of laparoscopy are discussed. In a series of 1000 laparoscopic sterilizations by the 2-incision technique, there was a total failure rate, surgical and operative, of .4%. In a similar series with the 1-incision technique and electrocagulation only, the total...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章

    doi:10.1097/00003081-197606000-00004

    authors: Wheeless CR Jr

    更新日期:1976-06-01 00:00:00

  • Breast Cancer Posttreatment Surveillance: Diagnosis and Management of Recurrent Disease.

    abstract::There has been a steady decline in breast cancer mortality that has led to a significant increase in the number of patients surviving breast cancer. We will review in this manuscript the evidence and guidelines for posttreatment surveillance of patients with breast cancer as well as the management options for patients...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0000000000000243

    authors: Karam AK

    更新日期:2016-12-01 00:00:00

  • Current evaluation and management of vulvovaginitis.

    abstract::There are many problems in the diagnosis and treatment of vaginitis. Often, the patient is not examined (telephone treatment) or examined improperly with lack of attention to the wet prep. In patients with recurrent vaginitis, it should not be assumed that the current infection is the same as a previous infection with...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/00003081-199906000-00004

    authors: Haefner HK

    更新日期:1999-06-01 00:00:00

  • Low-Molecular-Weight Heparin for the Prevention of Placenta-mediated Pregnancy Complications.

    abstract::During the past decade, prophylactic doses of low-molecular-weight heparin (LMWH) have been suggested to decrease the risk of placental-mediated complications. Herein, we review the prospective randomized trials that addressed the usefulness of LMWH in preventing placental-mediated complications in high-risk women. In...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0000000000000252

    authors: Haddad B,Lecarpentier E,Touboul C,Sibai BM

    更新日期:2017-03-01 00:00:00

  • New Developments in Minimally Invasive Gynecologic Oncology Surgery.

    abstract::Minimally invasive surgery continues to transform the field of gynecologic oncology and has now become the standard of care for many early-stage malignancies. The proven benefits of minimally invasive surgery are driving the rapid introduction and dissemination of novel technologies and the increasing ability to perfo...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0000000000000286

    authors: Stewart KI,Fader AN

    更新日期:2017-06-01 00:00:00

  • Neonatal abstinence syndrome: treatment and pediatric outcomes.

    abstract::Recent rise in rates of opiate replacement therapy among pregnant women have resulted in increasing number of infants requiring treatment for neonatal abstinence syndrome (NAS). Short-term and long-term developmental outcomes associated with prenatal opiate exposure are discussed, including symptoms and severity of NA...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0b013e31827feea4

    authors: Logan BA,Brown MS,Hayes MJ

    更新日期:2013-03-01 00:00:00

  • Reversible antepartum fetal distress.

    abstract::Information generated from the various tests of fetal well-being must be interpreted correctly to avoid unnecessary intervention for assumed fetal distress. This applies to both the intrapartum and antenatal period. The presence of normal data (e.g., reassuring fetal heart rate tracing) allows the woman to continue co...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/00003081-198712000-00023

    authors: Nageotte MP

    更新日期:1987-12-01 00:00:00

  • Dynamic ultrasound-based fetal assessment: the fetal biophysical profile score.

    abstract::The advent of ultrasound fetal imaging and the evolution of dynamic imaging (real-time) methods have opened great new vistas in which fetal responses can be monitored with remarkable precision and clarity. Contained within this new wealth of information may lie the key to direct determination of the fetus at risk for ...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/00003081-199503000-00006

    authors: Manning FA

    更新日期:1995-03-01 00:00:00

  • The modern role of reproductive surgery.

    abstract::The modern role of reproductive surgery has changed because of improved capabilities of endoscopic surgery resulting from innovation, instrumentation and experience, the development and increasing applicability of assisted reproductive technologies, and improved knowledge of the optimal application of these and other ...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0b013e3182353d86

    authors: Adamson GD

    更新日期:2011-12-01 00:00:00

  • Pharmacology of oxytocin and prostaglandins.

    abstract::Significant advances have been made in the last 20 years in our knowledge about the subcellular events occurring during myometrial contractions and cervical ripening and in the mechanism of action of oxytocin and prostaglandins. These advances have been instrumental in furthering our understanding of the mechanism of ...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/00003081-200009000-00006

    authors: Arias F

    更新日期:2000-09-01 00:00:00

  • Reproductive decision-making and determinants of contraceptive use in HIV-infected women.

    abstract::Perinatal transmission and reproductive decisions of HIV-infected women can be categorized in statistical and epidemiological terms. These reports and figures, however, do little to fully explain the complexities of human relationships, life experiences, personal and cultural influences, and situational and environmen...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/00003081-199606000-00008

    authors: Williams HA,Watkins CE,Risby JA

    更新日期:1996-06-01 00:00:00

  • Extraneous factors and their influences on fetal acid-base status.

    abstract::The relevance of extraneous factors on fetal and neonatal respiratory gas exchange and acid-base balance must be considered when interpreting umbilical cord blood values. However, although many of these factors can alter these values to a minor degree, the clinical impact is negligible in the unstressed fetus. The mor...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/00003081-199303000-00009

    authors: Yancey MK,Harlass FE

    更新日期:1993-03-01 00:00:00

  • Amniotic and thromboembolism.

    abstract::Embolic phenomena in pregnancy demand rapid investigation and treatment. Regardless, some patients will not survive due to the enormity of the insult. Optimally, such patients should be treated in tertiary care centers, but this is not always possible. ...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/00003081-199009000-00013

    authors: Chatelain SM,Quirk JG Jr

    更新日期:1990-09-01 00:00:00

  • The postpartum management of women with gestational diabetes using a continuum model for health care.

    abstract::Women with gestational diabetes mellitus require a continuum of care before, during, and after pregnancy for optimal management of hyperglycemia. Postpartum education and lifestyle modification should begin during pregnancy, and should continue during the postpartum period. Women should receive education on the long-t...

    journal_title:Clinical obstetrics and gynecology

    pub_type: 杂志文章,评审

    doi:10.1097/GRF.0b013e3182a8e0bb

    authors: Castorino K,Jovanovič L

    更新日期:2013-12-01 00:00:00