ABSTRACT
The evaluation of a young patient with chronic pelvic pain (CPP) can be one of the most challenging situations for the pediatrician and gynecologist alike. Often the most difficult aspect of providing care for these patients is the assessment phase, which may, in part, account for the long delays patients experience in both diagnosis and treatment. 1 Pain is a common and completely subjective condition, yet there is a lack of consensus as to how we should define chronic pain. The 2004 published guidelines from the American College of Obstetricians and Gynecologists (ACOG) define chronic pelvic pain as ‘non-cyclic pain of 6 or more months ’ duration that localizes to the anatomic pelvis, anterior abdominal wall at or below the umbilicus, the lumbo-sacral back, or the buttocks and is of sufficient severity to cause functional disability or lead to medical care. A lack of physical findings does not negate the significance of a patient ’ s pain, and normal examination results do not preclude the possibility of finding pelvic pathology’. 2 In fact, it is this lack of objective findings that maintains the diagnostic challenge.
