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Understanding Multisymptom Presentations in Chronic Pelvic Pain: The Inter-relationships Between the Viscera and Myofascial Pelvic Floor Dysfunction

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Abstract

Patients presenting with chronic pelvic pain frequently complain of multiple symptoms that appear to involve more than one organ system, creating diagnostic confusion. The multisymptom presentation of chronic pelvic pain has been frequently described. This article describes four proposed explanations for the clinical observation of multisymptom presentations of patients with chronic pelvic pain. These include the concepts of viscerovisceral convergence; viscerosomatic convergence; hypertonicity of pelvic floor muscles creating visceral symptoms along with somatovisceral convergence; and central sensitization with expansion of receptive fields.

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References

  1. Peters K et al. Characterization of a clinical cohort of 87 women with interstitial cystitis/painful bladder syndrome. Urology. 2008;71(4):634–40.

    Article  PubMed  Google Scholar 

  2. Berkley KJ. A life of pelvic pain. Physiol Behav. 2005;86(3):272–80.

    Article  PubMed  CAS  Google Scholar 

  3. Brinkert W et al. Dysmenorrhea is associated with hypersensitivity in the sigmoid colon and rectum. Pain. 2007;132(Suppl1):546–51.

    Google Scholar 

  4. Howard FM. Pelvic pain diagnosis and management. Lippincott Williams &Wilkins; 2000. p. 285.

  5. Giamberardino MA et al. Pain threshold variations in somatic wall tissues as a function of menstrual cycle, segmental site and tissue depth in non-dysmenorrheic women, dysmenorrheic women and men. Pain. 1997;71(2):7187–97.

    Article  Google Scholar 

  6. Wesselmann V et al. Mechanisms of referred visceral pain: uterine inflammation in the adult virgin rat results in neurogenic plasma extravasation in the skin. Pain. 1997;73:309–12.

    Article  PubMed  CAS  Google Scholar 

  7. Giamberardino MA, Berkley KJ. Influence of endometriosis on pain behaviors and muscle hyperalgesia induced by a urethral calculosis in female rats. Pain. 2002;95:247–57.

    Article  PubMed  Google Scholar 

  8. Travell J, Simons D. The trigger point manual, vol. 1. Baltimore: Williams & Williams; 1983.

    Google Scholar 

  9. Fitzgerald MP, Kotarinos R. Rehabilitation of the short pelvic floor. I: Background and patient evaluation. Int Urogynecol J. 2003;14:261–8.

    Article  CAS  Google Scholar 

  10. Weiss J. Chronic pelvic pain and myofascial trigger points. Pain Clin. 2000;2(6):13–8.

    Google Scholar 

  11. Doggweiler R, Jasmin L, Schmidt RA. Neurogenically mediated cystitis in rats: an animal model. J Urol. 1998;160:1551–6.

    Article  PubMed  CAS  Google Scholar 

  12. Latremoliere A, Woolf CJ. Central sensitization: a generator of pain hypersensitivity by central neural plasticity. J Pain. 2009;10(9):895–926.

    Article  PubMed  Google Scholar 

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Correspondence to Donna Hoffman.

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Hoffman, D. Understanding Multisymptom Presentations in Chronic Pelvic Pain: The Inter-relationships Between the Viscera and Myofascial Pelvic Floor Dysfunction. Curr Pain Headache Rep 15, 343–346 (2011). https://doi.org/10.1007/s11916-011-0215-1

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