Pelvic pain may be either acute ( less than 6 months in duration) or chronic ( on and off for more than 6 months)
Acute Pelvic Pain
Common causes include:
inflammatory disease (PID)
urinary tract infection (UTI)
miscarriage
ectopic pregnancy
torsion or rupture of ovarian cysts
General Aetiological Classification:
· Pregnancy-related:
miscarriage, ectopic pregnancy, rupture of corpus luteum cyst; causes in later pregnancy include premature labour, placental abruption and (rarely) uterine rupture.
· Gynaecological:
ovulation (mid-cycle, may be severe pain), dysmenorrhoea, PID, rupture or torsion of ovarian cyst, degenerative changes in a fibroid; the possibility of a pelvic tumour or pelvic vein thrombosis should also be considered.
· Other causes:
these include appendicitis, irritable bowel syndrome (IBS), adhesions, prostatitis, strangulated hernia.
Chronic pelvic pain
Chronic pelvic pain is defined as:
· Intermittent or constant pain in the lower abdomen or pelvis in women.
· Lasting for at least six months.
· Not occurring exclusively with menstruation or sexual intercourse.
· Not being associated with pregnancy.
Chronic pelvic pain is a symptom, not a diagnosis.
Aetiology (possible causes) of chronic pelvic pain include:
· Endometriosis.
· Pain tends to vary during menstrual cycle.
· Can be associated with dysmenorrhoea (pain during menstruation) and dyspareunia(pain during sexual intercourse)
· Adhesions.
caused by previous surgery, endometriosis, previous pelvic infection.
· Irritable Bowel Syndrome (IBS).
· Interstitial cystitis.
· Musculoskeletal problems.
· Prolapse of Pelvic organ.
· Nerve entrapment.
· Psychological and social problems.
· Depression and sleep disorders.
· Physical or sexual abuse as children.
· Other causes.
In men include
. Epididymo-orchitis.
. Testicular tumours.
. Chronic prostatitis.
. Prostate Pain Syndrome (PPS).