Assess Psychological Factors in Chronic Pelvic Pain Cases

By McNamara, Damian | Clinical Psychiatry News, May 2008 | Go to article overview

Assess Psychological Factors in Chronic Pelvic Pain Cases


McNamara, Damian, Clinical Psychiatry News


FORT LAUDERDALE, FLA. -- About 75% of premenopausal women with chronic pelvic pain gain significant relief from hysterectomy, even when no apparent physiologic cause is found. But what about the other 25%?

"We tend to look at fibroids and endometriosis. It behooves us to look at interstitial cystitis and muscle problems of the pelvic floor." It is important to avoid getting this 20%-25% of patients to hysterectomy, Dr. Charles E. Miller said at a meeting on hysterectomy sponsored by the Cleveland Clinic.

Do not stop at a diagnosis of endometriosis if symptoms suggest otherwise. Consider other etiologies, including irritable bowel disease, interstitial cystitis, and psychological factors, said Dr. Miller, director of minimally invasive gynecologic surgery at Lutheran General Hospital in Park Ridge, Ill.

Each year, about 75,000 of the more than 600,000 hysterectomies performed for benign disease are for relief of chronic pelvic pain. In a study of 99 women who reported persistent pelvic pain for 6 months who reported persistent pelvic pain for 6 months or more, 78% showed improvement a mean 22 months after laparoscopic hysterectomy (Obstet. Gynecol. 1990;75:676-9).

"You will see this number as we go through these slides. About three out of four women are going to gain significant relief with hysterectomy," said Dr. Miller, who is also on the obstetrics and gynecology faculty at the University of Illinois at Chicago. Other researchers confirmed this figure in subsequent studies (Obstet. Gynecol. Surv. 1993;48:357-87; Obstet. Gynecol. 1995;86:941-5).

"We must be able to do more. That is why we look for alternative diagnoses," Dr. Miller said. "Interestingly enough, there are a lot of studies that relate endometriosis and interstitial cystitis, and endometriosis and irritable bowel. So it's not enough to stop at endometriosis if symptoms suggest something else. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Assess Psychological Factors in Chronic Pelvic Pain Cases
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.