CHRONIC PELVIC PAIN - DIFFERENTIATING ANATOMIC FROM FUNCTIONAL CAUSES

Patients with chronic pelvic pain are challenging, from both diagnostic and therapeutic viewpoints. At the pain clinic at the Medical College of Georgia School of Medicine, Augusta, we have discovered over the past 3 years that psychiatric disease is probably under-recognized in these patients and that physicians are often reluctant to discuss intimate, details of a patient's sex life even though they may provide important information. In addition, sleep disorders are very prevalent. Use of vaginal-probe ultrasound may decrease the need for diagnostic laparoscopy, especially in patients without pelvic disease. In most cases, ovarian cysts in ovulating patients do not represent an abnormality. Laparoscopy and major pelvic surgery should be limited to patients with a high probability of anatomic abnormalities or persistent symptoms.