Differential diagnosis of chronic pelvic pain in women: The urologist's approach

Sophie G. Fletcher, Philippe E. Zimmern

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Chronic pelvic pain in women can be caused by a host of gynecological, gastrointestinal, musculoskeletal, neurologic, as well as urologic disorders. An initial broad differential diagnosis is essential. At times, overlapping symptoms and vague physical findings necessitate a multidisciplinary diagnostic approach. A thorough history, which is careful to characterize all aspects of the patient's symptoms, can usually direct the differential toward the bladder when this organ is the source of the pain. Interstitial cystitis/painful bladder syndrome (IC/PBS) should be included in the differential diagnosis, but it should not be used as an expeditious diagnosis when pain coexists with frequency and urgency. Multiple other urologic conditions such as overactive bladder, urinary tract infection, urethral diverticulum, periurethral masses (Skene gland cyst or abscess), and even urethral stricture disease, have overlapping symptom complexes with IC/PBS, and they must not be overlooked as they are much more easily diagnosed and treated. By using a stepwise approach and an evidence-based thought process, the obscurity of chronic bladder and urethral pain can evolve into a progressively narrowing differential.

Original languageEnglish (US)
Pages (from-to)557-562
Number of pages6
JournalNature Reviews Urology
Volume6
Issue number10
DOIs
StatePublished - 2009

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Interstitial Cystitis
Pelvic Pain
Chronic Pain
Differential Diagnosis
Pain
Urethral Diseases
Urinary Bladder
Urethral Stricture
Overactive Urinary Bladder
Diverticulum
Urinary Tract Infections
Abscess
Nervous System
Cysts
History
Urologists

ASJC Scopus subject areas

  • Urology

Cite this

Differential diagnosis of chronic pelvic pain in women : The urologist's approach. / Fletcher, Sophie G.; Zimmern, Philippe E.

In: Nature Reviews Urology, Vol. 6, No. 10, 2009, p. 557-562.

Research output: Contribution to journalArticle

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