School of Medicine


MDSG topics

Pelvic pain


                                                                                                                                                       Key
                                                                                                                                                       [R] = Review

                                                                                                                                                       [P] = Protocol

Painful menstruation (except when caused by specific pathology)

Medical Therapies

  • Analgesics
  • Antispasmodics
  • Nonsteroidal anti-inflammatory drugs
    [R] Nonsteroidal anti-inflammatory drugs for primary dysmenorrhoea
  • Oral contraceptive pill
    [R] Combined oral contraceptive pill (OCP) as treatment for primary dysmenorrhoeaa
  • Progestogens
  • Vasodilators
    [R] Beta2-adrenoceptor agonists for dysmenorrhoea

Surgery

  • Presacral neurectomy
    [R] Surgical interruption of pelvic nerve pathways for primary and secondary dysmenorrhoea
  • Laparoscopic uterine/uteroscral nerve ablation.
    [R] Surgical interruption of pelvic nerve pathways for primary and secondary dysmenorrhoeaea

Psychological Interventions

  • [R] Behavioural interventions for primary and secondary dysmenorrhoea.

Transcutaneous electrical nerve stimulation

  • [R] Transcutaneous electrical nerve stimulation and acupuncture for primary dysmenorrhoea a

Alternative therapies:

  • Acupuncture
    [R] Transcutaneous electrical nerve stimulation and acupuncture for primary dysmenorrhoea a
  • Spinal manipulation
    [R] Spinal manipulation for primary and secondary dysmenorrhoea
  • Herbal/Dietary Supplements
    [R] Chinese herbal medicine for primary dysmenorrhoea
    [R] Dietary supplements for dysmenorrhoea
  • Exercise
    [R] Exercise for dysmenorrhoea

Endometriosis/adenomyosis

Medical Therapies

  • Danazol
    [R] Danazol for pelvic pain associated with endometriosis
  • Gestrinone
  • Gonadotrophin releasing hormone
    [R] Gonadotrophin-releasing hormone analogues for pain associated with endometriosis
    [R] Gonadotrophin-releasing hormone analogues for endometriosis: bone mineral density
  • Hormone replacement therapy post pelvic clearance (surgical menopause)
  • Nonsteroidal anti-inflammatory drugs
    [P] Non-steroidal anti-inflammatory drugs for pain in women with endometriosis
  • Pre- and Post- operative medical treatment
    [R] Pre and post operative medical therapy for endometriosis surgery
  • Progestogens
    [R] Progestagens and anti-progestagens for pain associated with endometriosis
  • Oral contraceptive pill
    [R] Modern combined oral contraceptives for pain associated with endometriosis

Surgery

  • Drainage of endometriomas
  • Hysterectomy (with or without bilateral salpingo-oohorectomy)
  • Laparoscopic techniques - laser, diathermy [R] Laparoscopic surgery for pelvic pain associated with endometriosis
  • Laparoscopic uterine/uterosacral nerve ablation
  • Presacral neurectomy

Pelvic venous congestion

Medical Therapies

  • Gonadotrophin releasing hormones
  • Progestagens
  • Other hormonal/chemical agents
  • Vasoconstrictors

Surgery

Psychological Interventions

  • Psychotherapy

Other chronic pelvic pain (unspecified but excluding pathology)

Medical Therapies

  • Antidepressants
  • Local anaesthetic
  • Nonsteroidal anti-inflammatory drugs
  • Oral contraceptive pill

Psychological Interventions

  • Counselling
  • Photographic reinforcement

All

  • [R] Interventions for treating chronic pelvic pain in women

Ovarian remnant syndrome
Residual ovary syndrome  

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