Gynecol Obstet Fertil. 2001 Mar; 29(3): 234-43.

[Chronic pelvic pain. Another diagnostic and therapeutic approach]

Dellenbach P, Rempp C, Haeringer MT, Simon T, Magnier F, Meyer C.

Centre de la douleur pelvienne chronique, service de gynÃ©cologie, syndicat inter-hospitalier de la CommunautÃ© urbaine de Strasbourg (SIHCUS), centre mÃ©dico-chirurgical et obstÃ©trical (CMCO), 19, rue Louis-Pasteur BP 120, 67303 Schiltigheim, France.

Chronic pelvic pain (CPP) is a frequent and difficult problem because despite the quality and diversity of diagnostic procedures no relevant etiology will be found in 30 to 40% of all cases. Psychologic and psychotherapeutic counselling is than usually proposed and usually not well accepted. A different approach can now be proposed according to a new semeiologic overall. In many cases the pain dominant is not visceral but parietal. The pelvic envelope is actually more painfull than the pelvic content. In these cases one can evoke the diagnosis of pelvic fibromyalgia and this is quite similar to classic fibromyalgia. This pelvifibromyalgia can be quantified with an algometric index. This form of pain actually is the somatisation of a past and difficult issue which will be very slowly and progressively revealed in the realm of a multidisciplinary and simultaneous physical and psychological approach. In the majority of cases these women have occurred physical, moral or sexual trauma inflicted by family members or a third party. Taking in account the physical dimension of body pain at the same time as psychotherapy will considerably enhance the efficiency of treatment. In our experience 70% of all women will be cured using this new approach.