Premium
Role of a symptom‐based algorithmic approach to chronic pelvic pain
Author(s) -
Winkel C.A
Publication year - 2001
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/s0020-7292(01)00460-x
Subject(s) - medicine , endometriosis , pelvic pain , medical diagnosis , physical examination , quality of life (healthcare) , medical history , intensive care medicine , physical therapy , surgery , radiology , gynecology , nursing
Objective : Chronic pelvic pain (CPP) is a disorder that has a significant impact on the patient's quality of life. Laparoscopic diagnosis can be disappointing, and recurrence is common after surgical treatment. A symptom‐based algorithmic approach to treatment of CPP is presented that is safe and cost‐effective. Methods : This approach is oriented towards making a potential clinical diagnosis of endometriosis. It relies on a structured evaluation of the patient and administration of medical therapy including GnRH agonists to selected patients. Evaluation begins with a history and physical examination; selected cases receive specific therapy. Non‐responders undergo appropriate laboratory and imaging studies. If results remain negative, it is possible to make a clinical diagnosis of endometriosis and begin empiric treatment. Results : Early results strongly indicate that using this approach allowed clinicians to make highly accurate diagnoses (correct in 85–90% of cases). Conclusion : Use of this approach will minimize the need for surgery.