Chronic pelvic pain of obscure origin: A clinical study

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Abstract
A Pelvic Pain Clinic was established to provide diagnostic and therapeutic services to women with severe, chronic pelvic pain of obscure origin. Sixty such women were studied. Their histories revealed a complex pattern of complaints. Conventional clinical investigations usually failed to reveal organic pathology responsible for the symptoms. Twenty-eight patients consented to undergo surgery. Two patients were found to have gynaecological pathology causing prolonged pain. Seventeen patients had normal internal genitalia. Nine patients had minor gynaecological pathology, frequently observed in asymptomatic patients. Twenty-two patients underwent psychological evaluation. The interviews produced evidence of psychiatric syndromes in twenty-one. Patients improved with surgery if organic disease was found. The response to reassurance based on negative laparoscopic findings was also good. The majority of patients were distrustful of explanations involving psychosomatic concepts and were not amenable to group psychotherapy.

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