Most primary care physicians recognize chronic pelvic pain as a common clinical problem. As a multifactorial disease, it often challenges the best clinicians. Usually, evaluation is lengthy, and the relationship of findings to symptoms is uncertain. Treatment often is prolonged and incompletely successful, to the frustration of all involved. Consternation is common, especially for the surgery-oriented gynecologist, because the frequency of success is less than that usually seen in benign (and most malignant) gynecologic diseases.
From the standpoint of women's health care, chronic pelvic pain is a problem that requires substantial medical care resources.1 Outcome studies of common treatments, both medical and surgical, are needed to inform physicians more effectively of this process.
The purpose of this article is to review briefly the techniques of office evaluation of chronic pelvic pain (CPP). A more extensive volume on CPP is available elsewhere.2