PART 6. Is about PERIPHERAL NERVE SYNDROMES including and mainly about the pudendal nerve.
http://www.uroweb.org/gls/pdf/24_Chroni ... R%20II.pdf
This is the intro;
1. InTRoDUCTIon
1.1 The guideline
Chronic pelvic pain (CPP) is a prevalent condition which can present a major challenge to health care providers
due to its complex aetiology and poor response to therapy.
Chronic pelvic pain is a multifactorial condition and therefore, quite often, poorly managed. Management
requires knowledge of all pelvic organ systems and their association with other systems and conditions,
including musculoskeletal, neurologic, urologic, gynaecologic and psychological aspects, promoting a
multidisciplinary approach.
The European Association of Urology (EAU) Guidelines Working Group for Chronic Pelvic Pain prepared
this guidelines document to assist urologists and medical professionals from associated specialties, such
as gynaecologists, psychologists, gastroenterologists and sexologists, in assessing the evidence-based
management of CPP and to incorporate evidence-based recommendations into their every-day clinical
practice
I think we would all echo those sentiments.
I have only read it once (so far) and think it is very comprehensive although it does cover other pelvic problems that I know very little about it has to be noted that so far I have skipped through them.
I would also note that there is a LOT of talk about central sensitisation, social history, catastophising and depression.for example.
Chronic pelvic pain may be subdivided into conditions with well-defined classical pathology (such as infection
or cancer) and those with no obvious pathology. For the purpose of this classification, the term “specific
disease-associated pelvic pain” is proposed for the former, and “chronic pelvic pain syndrome” for the latter.
The following classification only deals with CPPS.
2.5.3.2 Definition of chronic pelvic pain syndrome
Chronic pelvic pain syndrome (CPPS) is the occurrence of CPP when there is no proven infection or other
obvious local pathology that may account for the pain. It is often associated with negative cognitive,
behavioural, sexual or emotional consequences, as well as with symptoms suggestive of lower urinary tract,
sexual, bowel or gynaecological dysfunction. CPPS is a subdivision of CPP.
They are terming a chronic pelvic pain problem without any definite pathological problem (infection, neuro problem, tumour, cyst etc) as chronic pelvic pain syndrome which is being attributed to people who are catastrophizers, may have a history of sexual abuse, depressed,without a quality of life,and may have a past history of pain syndromes etc (or any combo of the above)
This is fine, I'm sure there may be people with this tendency to catastrophize especially if life has not been kind to them in all manner of ways. HOWEVER, because the pelvic nerve pain issue is so little understood in the medical world and in the main not accepted it is far too easy for someone with a pudendal pain problem to be placed in this category.
The catch 22 is that as the problem is ignored, because of the lack of medical understanding and therefore not treated, there is more reason to display signs of depression and lack of life quality, resulting in a definition of CPPS!!!
I do hope that this guideline is given to all of the medical specialities mentioned and more.
I am going to use this very up to date guideline, in any more dealings I have with medical pelvic pain deniers, who should know better.
Take care all,
Helen
If you have read this far down you might as well sign the petition for spreading medical PN awareness if you haven't already done so. NO donation is required at the end
http://www.ipetitions.com/petition/requ ... g-for-all/
