ABSTRACT
This chapter will discuss chronic, nonmalignant pain syndromes of the abdomen, pelvis, and bladder and pain syndromes of the urogenital floor. Pain syndromes of the abdomen, pelvis, and bladder belong to the category of visceral pain. The first symptoms of visceral disease are usually discomfort and pain. These are the symptoms that prompt most patients with visceral disease to seek medical care. In clinical practice much emphasis has been placed on finding a specific etiology and specific pathological markers for visceral disease. Surprisingly, however, little attention has been paid to the clinical management of pain in visceral disease. Several reasons might account for this. Patients have difficulty in being able to describe and localize visceral pain, and physicians and other health care providers have difficulty in being able to examine and measure (quantify) visceral pain. Furthermore, the differential diagnosis of visceral disease is usually quite complex because the symptoms are often diffuse and nonspecific. Most efforts of health care personnel are spent on identifying the underlying etiology because this is an area that they have been trained in during their medical education. While many guidelines have been published on diagnosing and treating nonmalignant and malignant visceral disease, no specific guidelines yet exist on the management of visceral pain, and physicians and other health care providers are left without any concepts on the approach to the patient with visceral disease who presents with pain.
