Pelvic Pain in Women Diagnosis and Management

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.

1 General Aspects.- General Anatomy and Innervation of the Female Pelvis D.E. Sturdy.- Neurophysiology of Pain G.D. Thomas.- Psychological Aspects of Pelvic Pain J.M. Hughes.- 2 Examination and Investigation.- General and Surgical Examination D.E. Sturdy.- Gynaecological Examination and Investigation I. Rocker.- Orthopaedic Examination D.G. Jones.- Bacteriological Investigation of Genitourinary Infections E.J.G. Glencross.- Diagnostic Imaging A. Jones.- Laparoscopy I. Rocker.- 3 Reproduction and Pain.- Preadolescence.- Trauma.- Congenital Malformations.- Dysmenorrhoea.- Sexual Activity and Pelvic Pain.- Pregnancy.- 4 Vulva, Vagina and Perineum.- Vulva and Vagina I. Rocker.- Perineum D.E. Sturdy.- 5 Bladder and Renal Tract.- Pain in the Anterior (Urinary) Compartment of the Female Pelvis.- 6 Gynaecological Pain.- Uterovaginal Prolapse.- Uterine Malposition.- Pelvic Inflammatory Disease.- Endometriosis.- Genital Tract Tumours and Pelvic and Abdomino-pelvic Swellings.- Uterine Enlargement.- Post-hysterectomy Pain.- Gynaecalgia.- 7 Surgical and Orthopaedic Causes of Pelvic Pain.- Surgical Causes of Pelvic Pain D.E. Sturdy.- Orthopaedic Causes of Pelvic Pain D.G. Jones.- 8 Pain Management.- Mild Pain.- Moderate Pain.- Severe Pain.- Further Reading.