Chronic pelvic pain (CPP) — is discomfort in the lower abdomen or pelvis lasting more than 6 months. The pain may be constant or cyclical, accompanied by painful menstruation, discomfort during urination, defecation, or sexual intercourse.
Why the diagnosis is often delayed
- Symptoms overlap between urology, gynecology, gastroenterology, and orthopedics
- Specialists often see only their own field
- Patients undergo many tests and even surgeries without effect
- The main problem is the long wait for an accurate diagnosis and treatment
Urology
Painful bladder syndrome. Pain and frequent urges without infection.
Recurrent cystitis. Repeated UTIs, often after sexual activity.
Chronic prostatitis. Discomfort in men without infection.
Urethral syndrome. Burning and incomplete emptying.
Gynecology
Endometriosis. Cyclical pain in 10% of women of reproductive age.
Fibroids. Bleeding, organ pressure, pain.
Adenomyosis. More common after 40, painful menstruation.
Hydrosalpinx. Fluid in the fallopian tubes, often leading to infertility.
PID. Pelvic infections, risk of complications.
Venous congestion. Pelvic varicose veins, pain worsens before menstruation.
Gastroenterology
IBS. Pain, bloating, bowel dysfunction.
IBD. Crohn’s disease, ulcerative colitis.
Colorectal cancer. Pain and stool changes.
Hernias. Sometimes a cause of chronic pain.
Musculoskeletal system
Pelvic girdle pain. After pregnancy.
Levator syndrome. Pelvic floor muscle spasm.
Coccygodynia. Tailbone pain after trauma or prolonged sitting.
Pelvic floor prolapse. After childbirth, with incontinence.
Infections
Chlamydia, gonorrhea, herpes, etc. may cause pelvic pain and lead to infertility.
Conclusion
Chronic pelvic pain is a symptom, not a diagnosis. It requires a multidisciplinary approach, exclusion of dangerous causes, and individualized therapy.