Pelvic pain is pain in the area of the pelvis, and acute pain is more common than chronic pain.
If the pain lasts for more than six months, it is referred to be chronic, and a number of poorly understood conditions that may represent abnormal psychoneuromuscular function.
Most women, at some time experience pelvic pain.
Many different conditions can cause pelvic pain including:
exaggerated bladder, bowel, or uterine pain sensitivity
pelvic girdle pain
Pudendal nerve entrapment
Dysmenorrhea—pain during the menstrual period
Endometriosis—pain caused by uterine tissue that is outside the uterus.
Endometriosis can be visually confirmed by laparoscopy in approximately 75% of adolescent girls with chronic pelvic pain that is resistant to treatment, and in approximately 50% of adolescent in girls with chronic pelvic pain that is not necessarily resistant to treatment.
Müllerian abnormalities
Pelvic inflammatory disease
Ovarian cysts
Ovarian torsion
Ectopic pregnancy
Loin pain hematuria syndrome
Proctitis
Colitis
Appendicitis
Internal hernias
The diagnostic workup begins with a history and examination, followed by a pregnancy test.
The absence of visible pathology in chronic pain syndromes should not form the basis for either seeking psychological explanations or questioning the reality of the patient’s pain.
Management: consultation with a physical therapist, a trial of anti-inflammatory medications, hormonal therapy, or even neurological agents.
A hysterectomy is sometimes performed.
Male pelvic pain:
Chronic prostatitis/chronic pelvic pain syndrome also known as chronic nonbacterial prostatitis.
Men in this category have no known infection, but do have extensive pelvic pain lasting more than 3 months.
It is a diagnosis is by exclusion.
Multimodal therapy options ,includes: α-blockers,, and protocols aimed at quieting the pelvic nerves through myofascial trigger point release with psychological re-training for anxiety control.
Chronic pelvic pain is a common condition with rate of dysmenorrhoea between 16.8—81%, dyspareunia between 8—21.8%, and noncyclical pain between 2.1—24%.