Chronic Pelvic Pain: the Occurrence of Interstitial Cystitis in a Gynecological Population

Overview

Journal JSLS

Specialty General Surgery

Date 2005 Dec 31

PMID 16381360

Citations 7

Authors

John D Paulson

Melissa Delgado

Affiliations

Soon will be listed here.

Abstract

Objective: The objective of this study was to determine what relationship exists between interstitial cystitis and chronic pelvic pain in patients.

Methods: A prospective study of 35 women with a complaint of chronic pelvic pain was performed between August 2002 and September 2003. These patients underwent a workup to exclude other causes of pelvic pain and underwent a laparoscopy and a cystoscopy with hydrodistention at 80 cm of hydrostatic water pressure. Results were obtained and quantified.

Results: Twenty-eight patients (80%) were diagnosed with interstitial cystitis, 28 were diagnosed with endometriosis (80%), 24 had both disease entities simultaneously (69%), and 32 (91%) had endometriosis, interstitial cystitis, or both. Three patients (9%) had neither and were diagnosed with other pathologies.

Conclusions: Chronic pelvic pain is a major concern for many women in the United States. Patients with chronic pelvic pain have traditionally been difficult to manage. A large percentage of women presenting with chronic pelvic pain have been shown to have endometriosis, interstitial cystitis, or both. Therefore, an appropriate workup for those individuals with chronic pelvic pain involves not only obtaining a good history and performing a good physical examination, but the possibility of a cystoscopy being performed when a laparoscopy has been deemed necessary for diagnosis of the pain. These procedures can serve as both a means for diagnosis and short-term treatment of these problems when encountered.

Citing Articles

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Ectopic endometriosis in the pelvic cavity evokes bladder hypersensitivity via transient receptor potential ankyrin 1 hyperexpression in rats.

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References

Carter J . Combined hysteroscopic and laparoscopic findings in patients with chronic pelvic pain. J Am Assoc Gynecol Laparosc. 1994; 2(1):43-7. DOI: 10.1016/s1074-3804(05)80830-8. View

Chung M, Chung R, Gordon D, Jennings C . The evil twins of chronic pelvic pain syndrome: endometriosis and interstitial cystitis. JSLS. 2002; 6(4):311-4. PMC: 3043443. View

. Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil Steril. 1997; 67(5):817-21. DOI: 10.1016/s0015-0282(97)81391-x. View

HOWARD F . The role of laparoscopy in chronic pelvic pain: promise and pitfalls. Obstet Gynecol Surv. 1993; 48(6):357-87. DOI: 10.1097/00006254-199306000-00001. View

Bunyavejchevin S, Rungruxsirivorn T, Pinchantra P, Wisawasukmongchol W, Suwajanakorn S, Limpaphayom K . Laparoscopic finding in Thai women with chronic pelvic pain. J Med Assoc Thai. 2003; 86 Suppl 2:S404-8. View

Yaseen S . A positive proof for the theory of coelomic metaplasia. Am J Obstet Gynecol. 1980; 137(1):137-40. DOI: 10.1016/0002-9378(80)90399-3. View

Stovall T, Ling F, Crawford D . Hysterectomy for chronic pelvic pain of presumed uterine etiology. Obstet Gynecol. 1990; 75(4):676-9. View

van de Merwe J, Arendsen H . Interstitial cystitis: a review of immunological aspects of the aetiology and pathogenesis, with a hypothesis. BJU Int. 2000; 85(8):995-9. DOI: 10.1046/j.1464-410x.2000.00646.x. View

Yamada T, Murayama T, Andoh M . Adjuvant hydrodistension under epidural anesthesia for interstitial cystitis. Int J Urol. 2003; 10(9):463-8; discussion 469. DOI: 10.1046/j.1442-2042.2003.00664.x. View

10.

Stripling M, Martin D, Chatman D, ZWAAG R, Poston W . Subtle appearance of pelvic endometriosis. Fertil Steril. 1988; 49(3):427-31. DOI: 10.1016/s0015-0282(16)59767-2. View

11.

Stone A, Quattrocchi K, Miller C, MacDermott J . Role of the immune system in interstitial cystitis. Semin Urol. 1991; 9(2):108-14. View

12.

Ling F . Randomized controlled trial of depot leuprolide in patients with chronic pelvic pain and clinically suspected endometriosis. Pelvic Pain Study Group. Obstet Gynecol. 1999; 93(1):51-8. DOI: 10.1016/s0029-7844(98)00341-x. View

13.

Mathur S, Peress M, WILLIAMSON H, Youmans C, Maney S, Garvin A . Autoimmunity to endometrium and ovary in endometriosis. Clin Exp Immunol. 1982; 50(2):259-66. PMC: 1536699. View

14.

Reiter R . A profile of women with chronic pelvic pain. Clin Obstet Gynecol. 1990; 33(1):130-6. View

15.

HOWARD F . The role of laparoscopy as a diagnostic tool in chronic pelvic pain. Baillieres Best Pract Res Clin Obstet Gynaecol. 2000; 14(3):467-94. DOI: 10.1053/beog.1999.0086. View

16.

Nisolle M, Paindaveine B, Bourdon A, Berliere M, Donnez J . Histologic study of peritoneal endometriosis in infertile women. Fertil Steril. 1990; 53(6):984-8. DOI: 10.1016/s0015-0282(16)53571-7. View

17.

ORAVISTO K . Interstitial cystitis as an autoimmune disease. A review. Eur Urol. 1980; 6(1):10-3. DOI: 10.1159/000473278. View

18.

Suginami H . A reappraisal of the coelomic metaplasia theory by reviewing endometriosis occurring in unusual sites and instances. Am J Obstet Gynecol. 1991; 165(1):214-8. DOI: 10.1016/0002-9378(91)90254-o. View

19.

Butrick C . Interstitial cystitis and chronic pelvic pain: new insights in neuropathology, diagnosis, and treatment. Clin Obstet Gynecol. 2003; 46(4):811-23. DOI: 10.1097/00003081-200312000-00011. View

20.

Ueki M . Histologic study of endometriosis and examination of lymphatic drainage in and from the uterus. Am J Obstet Gynecol. 1991; 165(1):201-9. DOI: 10.1016/0002-9378(91)90252-m. View