The DOI matches its Crossref record; 79 of the 79 references it cites were found in a registry or an index.
Chronic pelvic pain in women: etiology, pathogenesis and diagnostic approach
Abstract
Chronic pelvic pain (CPP), defined as non-cyclic pain of 6 or more months, is a frequent disorder that may negatively affect health-related quality of life. In women several causes are recognised, although in a not negligible proportion of patients a definite diagnosis cannot be made. Different neurophysiological mechanisms are involved in the pathophysiology of CPP. Pain may be classified as nociceptive or non-nociceptive. In the first case the symptom originates from stimulation of a pain-sensitive structure, whereas in the second pain is considered neuropatic or psychogenic. Patients history is crucial and is generally of utmost importance for a correct diagnosis, being sometimes more indicative than several diagnostic investigations. The main contributing factors in women with CPP can still be identified by history and physical examination in most cases. Many disorders of the reproductive tract, urological organs, gastrointestinal, musculoskeletal and psycho-neurological systems may be associated with CPP. Excluding endometriosis, the most frequent causes of CPP are: post-operative adhesions, pelvic varices, interstitial cystitis and irritable bowel syndrome. CPP is a symptom, not a disease, and rarely reflects a single pathologic process. Gaining women's trust and developing a strong patient-physician relationship is of utmost importance for the long-term outcome of care.
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In the citing paper
“The fact that surgical removal or destruction of lesions alleviates pain in some patients indicates that lesions contribute to pain (Vercellini et al., 2009b)”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Vercellini et al., 2009b
In the citing paper
“Treating endometriomas is not straightforward as their association with pain is unclear (Chapron et al., 2002;Vercellini et al., 2009b).”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Vercellini et al., 2009b
In the citing paper
“Furthermore, not all women undergoing re-operation have endometriosis at second surgery (Vercellini et al., 2009b)”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Vercellini et al., 2009b
In the citing paper
“Third, severity of pain symptoms does not correlate with extent of disease (Kennedy et al., 2005;Vercellini et al., 2009b).”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Vercellini et al., 2009b
In the citing paper
“Treating DIE lesions has a greater potential for benefit than treating other lesion types (Fauconnier and Chapron, 2005;Vercellini et al., 2009b).”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Vercellini et al., 2009b
In the citing paper
“First, seemingly complete surgical removal fails to alleviate pain for at least a year in up to 50% of carefully selected patients (Vercellini et al., 2009b).”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Vercellini et al., 2009b
In the citing paper
“The approach to surgical treatment of endometriosis in women with CPP is based on the oncologic principle of removing all lesions (Howard, 2003;Vercellini et al., 2009b).”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Vercellini et al., 2009b
In the citing paper
“Second, even in patients whose pain was alleviated by surgically treating lesions, pain often returns, sometimes without evidence of new lesions (Abbott et al., 2003;Vercellini et al., 2009b).”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Vercellini et al., 2009b
In the citing paper
“Although excision of the pseudocapsule helps to prevent recurrence”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Vercellini et al., 2009b
In the citing paper
“excision may lead to diminished ovarian reserve, subsequent infertility and premature ovarian insufficiency (Vercellini et al., 2006b(Vercellini et al., , 2009b)).”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Vercellini et al., 2009b
In the citing paper
“Visual survey at surgery is the accepted standard, but may not accurately catalogue the location, depth and extent of lesions.”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Vercellini et al., 2009b
In the citing paper
“The role of adhesions in pain and endometriosis is poorly understood”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Vercellini et al., 2009b
In the citing paper
“Furthermore, minimal and mild disease are not necessarily histologically confirmed, which may result in misclassifying cases”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Vercellini et al., 2009b
In the citing paper
“women with endometriosis have a higher rate of other pain syndromes associated with peripheral and central sensitization such as irritable bowel syndrome, painful bladder syndrome, fibromyalgia and migraine headache”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Vercellini et al., 2009c
In the citing paper
“Third, change in endometriosis score has been used to assess treatment effect with the assumption, but no evidence, that lesion score correlates with pain score”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Vercellini et al., 2009b
Citations
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Cited by
Sorted by citations
Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications
Stratton, P., & Berkley, K. J. (2011) · Human Reproduction Update · doi:10.1093/humupd/dmq050 · Cited by 442
Zanatta, A., da Rocha, A. M., Carvalho, F. M., Pereira, R., Taylor, H. S., Motta, E. L. A., Baracat, E. C., & Serafini, P. C. (2010) · Journal of Assisted Reproduction and Genetics · doi:10.1007/s10815-010-9471-y · Cited by 209
Pascoal, E., Wessels, J. M., Aas‐Eng, M. K., Abrão, M. S., Condous, G. S., Jurkovic, D., Espada, M., Exacoustós, C., Ferrero, S., Guerriero, S., et al. (2022) · Ultrasound in Obstetrics and Gynecology · doi:10.1002/uog.24892 · Cited by 220
Moloney, R. D., O’Mahony, S. M., Dinan, T. G., & Cryan, J. F. (2015) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2015.00015 · Cited by 171
Ovarian hormones and chronic pain: A comprehensive review
Hassan, S. I., Muere, A., & Einstein, G. (2014) · Pain · doi:10.1016/j.pain.2014.08.027 · Cited by 115
Metadata
- Authors
- Vercellini, P., Somigliana, E., Viganò, P., Abbiati, A., Barbara, G., & Fedele, L.
- Affiliations
- University of Milan (IT)
- Corresponding author
- Vercellini, Paolo
- Venue
- Gynecological Endocrinology
- Publisher
- Informa UK Limited
- Published
- 2009-01
- Volume
- 25
- Issue
- 3
- Pages
- 149-158
- ISSN
- 0951-3590 (ISSN-L)
- 1473-0766
- OpenAlex
- W2117120599
- Cited by
- 138
- References
- 79
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 5 · 2023: 10 · 2022: 9 · 2021: 6 · 2020: 7 · 2019: 3 · 2018: 11 · 2017: 8 · 2016: 13 · 2015: 11 · 2014: 13 · 2013: 8 · 2012: 5
- FWCI
- 9.03
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Gynecological Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Università degli Studi di Milano
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Menstrual Health and Disorders
- Keywords
- chronic pelvic pain, women, etiology, pathogenesis, neurophysiological mechanisms, nociceptive pain, neuropathic pain, psychogenic pain, diagnostic approach, medical history, endometriosis, postoperative adhesions, pelvic varices, interstitial cystitis, irritable bowel syndrome, reproductive tract disorders, urological diseases, musculoskeletal disorders, health-related quality of life, physician-patient relationship
- MeSH terms
- Chronic Disease, Family Health, Female, Gynecology, Humans, Reproductive History, Pelvic Pain
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