Pelvic pain in terms of an interdisciplinary approach in patient treatment (literature review)
Authors:   Federal State Budgetary Educational Institution of Higher Education «Tver State Medical University» of the Ministry of Health of the Russian Federation, Chichanovskaya L. V. , Sorokovikova T. V. ,   Federal State Budgetary Educational Institution of Higher Education «Tver State Medical University» of the Ministry of Health of the Russian Federation, Morozov A. M. ,   Federal State Budgetary Educational Institution of Higher Education «Tver State Medical University» of the Ministry of Health of the Russian Federation, Minaeva Ya. R. ,   Federal State Budgetary Educational Institution of Higher Education «Tver State Medical University» of the Ministry of Health of the Russian Federation, Golubeva Yu. A. ,   Federal State Budgetary Educational Institution of Higher Education «Tver State Medical University» of the Ministry of Health of the Russian Federation, Vorobiev G. D. ,   Federal State Budgetary Educational Institution of Higher Education «Tver State Medical University» of the Ministry of Health of the Russian Federation
Published: October 2024

Pelvic pain is one of the most significant problems in clinical practice. The issues of diagnosis and classification of disorders associated with pain in the pelvic girdle remain controversial, despite numerous studies in this area. Most disorders associated with chronic pelvic pain (CPP) do not have a specific pathological basis, which remains a blank spot in clinical practice. After analyzing modern literary sources, it can be considered that chronic pelvic pain syndrome (CPPS) has a multifactorial nature, since it occurs under the influence of the psychological aspect together with disorders occurring in the endocrine, nervous, and immune systems of the human body. When a patient seeks help for constant pelvic pain, a correct and thorough anamnesis plays a decisive role. Success in diagnosis and treatment depends 90 % on the quality of information collected about the patient's condition. To determine the cause of chronic pelvic pain, it is necessary to exclude or confirm the influence of many factors, especially urological, gynecological, gastrointestinal, and neurological ones. CPPS can occur for various reasons. Of these, 40 % of cases are due to varicose veins of the pelvic veins; in 25 % of cases, endometriosis is detected; chronic inflammatory diseases of the small organs account for no more than 15 % of cases. Much less common are benign tumors of the uterus and appendages and adhesions in the small pelvis, accounting for up to 12 % and up to 6 % of cases, respectively. No less important are causes unrelated to the reproductive organs, such as interstitial cystitis, spastic colitis, and hypertonicity of the pelvic floor muscles (2 % of cases). After a detailed study and differentiation of the causes of chronic pelvic pain, there is no doubt that the optimal approach to understanding the pathogenesis of pelvic pain is an integrated approach that includes somatic and mental components, and diagnosis and treatment of pain syndromes should be carried out by a team of specialists, since in this case only an interdisciplinary approach is effective.