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Pelvic pain, bowel and urinary symptoms do not predict advanced disease
Stage I & II (n=423)
Stage III & IV (n=523)
Dysmenorrhea Pelvic pain
Bowel upset Bowel pain Dysuria
vs
78.5% vs. 78.9% 71.4% vs. 67.7%
33.8% vs. 38.5% 27.0% vs 30.8% 11.4% vs. 8.7%
(p=0.95) (p=0.25)
(p=0.29) (p=0.23) (p=0.21)
No difference in pelvic pain symptoms
No difference in bowel or urinary symptoms
Sinaii et al. Fertil Steril 2008 Mar;89(3):538-45
Conditions that cause chronic pelvic & abdominal pain
Gynecologic
• Endometriosis
• Adenomyosis
• Primary Dysmenorrhea • Adhesions
• Uterine fibroids
• Pelvic congestion
• Ovarian remnant
Yes  Yes  Yes  Yes  Yes  Yes  Yes
Urologic
Gastrointestinal
Musculoskeletal
• Pelvic floor myalgia • Trigger points
• Low back pain
• Disc disease
• SI joint disease • Coccydynia
 Yes  Yes Yes  Yes  Yes  Yes  Yes
Peripheral nerves
•Peripheral nerve injury
 Yes
Pelvic Pain
Pain worse w menses Dyspareunia
Bowel dysfunction Dyschezia
Urinary dysfunction Dysuria
• Interstitial Cystitis/Painful Bladder Syndrome
• Urethral syndrome • Chronic UTI
• Bladder stones
 Yes  Yes Yes
Yes Yes
• IBS
• Chronic constipation • Chronic appendicitis • IBD
• Hernias
• Diverticular disease
 Yes  Yes
 Yes  Yes
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PRECONGRESS COURSE 03 I VIENNA, AUSTRIA – 23 JUNE 2019 11