Evaluation and management of chronic pelvic pain

Antoni J. Duleba, Martin D. Keltz, David L. Olive

Research output: Contribution to journalReview articlepeer-review

27 Scopus citations


Evaluating patients with chronic pelvic pain is complex. A detailed medical history should be ideally supplemented by psychologic evaluation and assessment of the woman's social background. At the time of physical examination, the location and intensity of the pain should be mapped. Assessment of pain relief with the administration of a local anesthetic to trigger points or selected nerves may be useful in predicting the potential efficacy of surgical interventions such as uterosacral nerve ablation. Appropriate tests include pelvic ultrasound and magnetic resonance imaging. Ultimately, laparoscopy may provide the final diagnosis. Management should address the underlying cause(s) of pain; when this cannot be done, it should focus on treating the pain itself. When appropriate, empiric administration of antidepressants may be considered. In selected women, therapeutic goals may be achieved by electrical stimulation of nerves.

Original languageEnglish
Pages (from-to)205-227
Number of pages23
JournalJournal of the American Association of Gynecologic Laparoscopists
Issue number2
StatePublished - Feb 1996
Externally publishedYes


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