ABSTRACT

Chronic pelvic pain (CPP) is a frustrating clinical condition affecting roughly 9 million women each year. The American College of Obstetricians and Gynecologists defines the disorder as noncyclic lower abdominal pain persisting for at least six months with enough severity to cause functional incapacity or require medical or surgical care. Pain is localized in the anatomic pelvis, which includes the anterior abdominal wall below the umbilicus, the lumbosacral back, and the buttocks. Causes of pain may be difficult to attribute to a single origin. For example, sources of pain can be visceral or somatic. Visceral origins of CPP arise in reproductive, genitourinary, vascular, and gastrointestinal regions of the body. Somatic sources include the pelvic bones, ligaments, muscles, skin of the abdomen and perineum, and fascia. Approximately two-thirds of women suffering from CPP do not undergo diagnostic testing and are never referred to a specialist for diagnosis or treatment.