The History of Gynecological Treatment of Women’s Pelvic Pain and the Recent Emergence of Pain Sensitization is a historical account on how women have been treated for the problems of pelvic pain. It describes the earliest reports of women suffering from pelvic pain that seem to suggest the presence of something beyond any understanding prior to the late twentieth century. This book is for awareness of the condition and will help readers understand the complex presentations of pelvic pain: the shift from episodic to persistent pain, referred pain, pain from a non-painful stimulus (allodynia), and excessive pain from a painful stimulus (hyperalgesia). This is a novel reference that provides a detailed chronology of past treatments and how the absence of awareness of pain sensitization led to some disreputable surgical procedures. In addition, it is an historical analysis on the emergence of central pain sensitization as an explanation for the historical challenges of the past to current developments. Discusses co-morbidities and possible reversal approaches Provides information on what to look for with pelvic pain to give guidance for potential solutions Covers early women gynecologists and early developments in surgical practice

The History of Gynecological Treatment of Women's Pelvic Pain and the Recent Emergence of Pain Sensitization is a historical account on how women have been treated for the problems of pelvic pain. It describes the earliest reports of women suffering from pelvic pain that seem to suggest the presence of something beyond any understanding prior to the late twentieth century. This book is for awareness of the condition and will help readers understand the complex presentations of pelvic pain: the shift from episodic to persistent pain, referred pain, pain from a non-painful stimulus (allodynia), and excessive pain from a painful stimulus (hyperalgesia). This is a novel reference that provides a detailed chronology of past treatments and how the absence of awareness of pain sensitization led to some disreputable surgical procedures. In addition, it is an historical analysis on the emergence of central pain sensitization as an explanation for the historical challenges of the past to current developments.

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.

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

Pelvic pain in the female patient is common in gynaecological practice, but the specialties of general surgery, urology and orthopaedics provide a significant number of patients and problems. These patients may suffer a multitude of symptoms, and only careful analysis and investigation of each individual problem by the doctor concerned will lead to correct diagnosis and management. The subject matter of this book lies in the practice of many specialties, and all are combined here in a coherent whole. This emphasises the close collaboration necessary between family practitioners, junior hospital staff and consultants. The authors are consultants who work together in a busy district general hospital, and their experience and collaboration is evident in the approach to the diagnosis and management of pelvic pain in the female. Emphasis is laid on the careful evaluation of history and examination and the correct interpretation of diagnostic investigations. Full details of radiology, ultrasound scanning, endoscopy, peritoneoscopy and bacteriological investigation are given. Full consultation between members of staff who have special experience in these investigative procedures is of paramount importance. Details of treatment for relief of pain are important to all doctors concerned with this aspect of clinical management. and this section will be of particular value. The blending of these specialties allows full consideration of the problems affecting the patients. Careful management leads to better treatment for the patient and better satisfaction for the doctor.

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.

A new addition to the Gynecology in Practice series, Chronic Pelvic Pain provides a practical guide to diagnosing and treating chronic pelvic pain in women. Emphasizing diagnosis, management and psychological aspects, the book assists gynecologists to better care for their patients suffering from this condition. As a part of the series, various feature boxes are highlighted throughout. "Tips and Tricks" give suggestions on how to improve outcomes through practical technique or patient questioning. In addition, "Caution" warning boxes supply helpful advice on how to avoid problems and "Science Revisited" boxes offer quick reminders of the basic science principles necessary for understanding the presented concepts.