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Int J Gynaecol Obstet. 2001 Sep;74 Suppl 1:S15-20.

Role of a symptom-based algorithmic approach to chronic pelvic pain.

Author information

1
Department of Obstetrics and Gynecology, Georgetown University Medical Center, Washington, DC, USA.winkelc@gunet.georgetown.edu

Abstract

OBJECTIVE:

Chronic pelvic pain (CPP) is a disorder that has a significant impact on the patient's quality of life. Laparoscopic diagnosis can be disappointing, and recurrence is common after surgical treatment. A symptom-based algorithmic approach to treatment of CPP is presented that is safe and cost-effective.

METHODS:

This approach is oriented towards making a potential clinical diagnosis of endometriosis. It relies on a structured evaluation of the patient and administration of medical therapy including GnRH agonists to selected patients. Evaluation begins with a history and physical examination; selected cases receive specific therapy. Non-responders undergo appropriate laboratory and imaging studies. If results remain negative, it is possible to make a clinical diagnosis of endometriosis and begin empiric treatment.

RESULTS:

Early results strongly indicate that using this approach allowed clinicians to make highly accurate diagnoses (correct in 85-90% of cases).

CONCLUSION:

Use of this approach will minimize the need for surgery.

PMID:
11549395
[Indexed for MEDLINE]

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