Format

Send to

Choose Destination
See comment in PubMed Commons below
World J Gastroenterol. 2011 Oct 28;17(40):4447-55. doi: 10.3748/wjg.v17.i40.4447.

Chronic proctalgia and chronic pelvic pain syndromes: new etiologic insights and treatment options.

Abstract

This systematic review addresses the pathophysiology, diagnostic evaluation, and treatment of several chronic pain syndromes affecting the pelvic organs: chronic proctalgia, coccygodynia, pudendal neuralgia, and chronic pelvic pain. Chronic or recurrent pain in the anal canal, rectum, or other pelvic organs occurs in 7% to 24% of the population and is associated with impaired quality of life and high health care costs. However, these pain syndromes are poorly understood, with little research evidence available to guide their diagnosis and treatment. This situation appears to be changing: a recently published large randomized, controlled trial by our group comparing biofeedback, electrogalvanic stimulation, and massage for the treatment of chronic proctalgia has shown success rates of 85% for biofeedback when patients are selected based on physical examination evidence of tenderness in response to traction on the levator ani muscle--a physical sign suggestive of striated muscle tension. Excessive tension (spasm) in the striated muscles of the pelvic floor appears to be common to most of the pelvic pain syndromes. This suggests the possibility that similar approaches to diagnostic assessment and treatment may improve outcomes in other pelvic pain disorders.

KEYWORDS:

Biofeedback; Chronic pelvic pain; Chronic proctalgia; Coccygodynia; Levator ani syndrome; Pudendal neuralgia

PMID:
22110274
PMCID:
PMC3218134
DOI:
10.3748/wjg.v17.i40.4447
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Baishideng Publishing Group Inc. Icon for PubMed Central
    Loading ...
    Support Center