This issue of Obstetrics and Gynecology Clinics of North America attempts to provide an overview of the more common causes of chronic pelvic pain in women. It brings together experts in various fields of gynecology, gastroenterology, physical therapy, and urogynecology in an attempt to discuss the wide variety of common clinical conditions that can manifest as pain. The intent is to enable the physician to consider not only the common gynecologic causes but also the common nongynecologic causes based on certain symptom profiles and targeted clinical examination. Should the physician not feel comfortable in treating the nongynecologic causes, it would enable them to target their referral to a more appropriate physician rather than the patient being referred back to a general primary care physician. It is our hope that it will enable the reader to see the pelvis not as an ovary or a uterus but as a whole system of interacting organs, muscles, and nerves. In addtiion, there is very little in the Obstetrics and Gynecology literature about the treatment of the pain component with opioid and nonopioid medications. As one of my colleagues frequently states, we can treat the pain but not necessarily alleviate the suffering. The overview of complementary and alternative medications and opioid use will hopefully be useful to the practicing physician as it provides an evidence-based approach to the use of these therapies specifically for chronic pelvic pain.

The number of studies on chronic and recurrent pain bears no relation to the frequency of these complaints in gynecologic practice, nor to the clinical and scientific problems that still need solving in this area. Several factors stand in the way of progress in this field, such as the strongly subjective nature of the complaints, the frequent lack of correlation between them and objective findings, and the complexity of the psychosomatic interac tions involved. Although progress in our knowledge has been much slower than we would have wished, and although we are well aware of these many gaps, it was considered useful to gather in a book what we think we have learned during 3 decades of active interest in pain patients and pain problems in gynecologic practice and 12 years of supervision of a pain clinic in the Department of Obstetrics and Gynecology of Leuven University. As there are many differences between acute pain - clinical as well as experi mental - on the one hand and chronic pain symptoms on the other, it was felt preferable to limit the scope of this book essentially to chronic and recurrent pain in gynecologic practice. When presented with a complaint of lower abdominal and/or low back pain, the gynecologist should constantly be on the lookout for nongynecologic causes, of which the most frequent will be either gastroenterologic or orthopedic and sometimes urologic. I have been fortunate in obtaining the collaboration of Dr.

The most comprehensive evidence-based guide to both obstetrics and gynecology Aimed at practicing obstetricians, gynecologists, and trainees in the specialty, Evidence-based Obstetrics and Gynecology concentrates on the clinical practice areas of diagnosis, investigation and management. The first section of the book discusses evidence-based medicine methodology in the context of the two specialties. The second and third sections cover all the major conditions in obstetrics and gynecology, with each chapter reviewing the best available evidence for management of the particular condition. The chapters are structured in line with EBM methodology, meaning the cases generate the relevant clinical questions. Evidence-based Obstetrics and Gynecology provides in-depth chapter coverage of abnormal vaginal bleeding; ectopic pregnancy; pelvic pain; lower genital tract infections; contraception and sterilization; breast diseases; urogynecology; endocrinology and infertility; puberty and precocious puberty; cervical dysplasia and HPV; cervical, vaginal, vulvar, uterine, and ovarian cancer; preconception care; prenatal care and diagnosis; drugs and medications in pregnancy; maternal complications; chronic hypertension; diabetes mellitus; thyroid disease; neurologic disease; psychiatric disease; postterm pregnancy; fetal complications; preeclampsia; and more. First book to address evidence-based practice for obstetrics and gynecology combined EBM is a highly relevant approach for this high risk specialty Edited by leading US specialist involved in the evidence-based medicine movement Evidence-Based Obstetrics and Gynecology is an important text for obstetricians and gynecologists in practice and in training, as well as for specialist nurses.

Edited by two leading general practitioners and with contributions from over 20 authors, this book covers a wide range of topics to do with narrative in medicine. It includes a wealth of real examples of patients narratives and addresses theoretical and practical issues including the use of narrative as a therapeutic tool, teaching narrative to students, philosophical issues, narrative in legal and ethical decisions, narrative in nursing, and the narrative medical record.

First book devoted to the diagnosis and treatment of sexual pain in women Female Sexual Pain Disorders is a remarkable fusion of clinical and scientific knowledge that will empower women’s healthcare professionals to help their patients in overcoming this common debilitating disorder. Based on the highest level research, it provides state-of-the-art practical guidance that will help you to: Evaluate and distinguish the causes of sexual pain in women Differentiate the many forms of sexual pain Implement multidisciplinary treatments Distilling the experience of world leaders across many clinical, therapeutic and scientific disciplines, with an array of algorithms and diagnostic tools, Female Sexual Pain Disorders is your ideal companion for treating the many millions of women who suffer from this disorder worldwide. All proceeds from this book are being donated to the International Society for the Study of Women’s Sexual Health (ISSWSH).

Based on the gold-standard nondrug, nonsurgical Wise-Anderson Protocol for treating chronic pelvic pain, A Headache in the Pelvis is the definitive resource for anyone suffering from pelvic pain. Pelvic pain afflicts millions of men and women and goes by many names, including pelvic floor dysfunction and prostatitis. David Wise, Ph.D., searched for relief for his pelvic pain for more than 20 years. After researching medical journals and performing outside-the-box self-experimentation, he found a way to resolve his symptoms. He then joined forces with Stanford urologist Dr. Rodney Anderson in the mid-1990s, and together they treated patients and did research on what is now called the Wise-Anderson Protocol. Often incorrectly diagnosed, debilitating, and disruptive, pelvic pain is correlated with psychological distress. Using a holistic treatment integrating physical therapy and meditative relaxation, this book guides you through understanding your pain, why conventional treatments haven't worked, and describes the details of the physical and behavioral protocol that can help to heal the painful pelvic floor. At last, this life-changing protocol offers hope and help to lead a pain-free life.

A practical manual on the treatment of pelvic pain, focusing on the many gynecological and non-gynecological causes of the condition.