• F Siedentopf and M Sillem.
• Klinik für Gynäkologie und Geburtshilfe, Martin-Luther-Krankenhaus, Caspar-Theyß-Str. 27-31, 14193, Berlin, Deutschland, friederike.siedentopf@gmx.de.
• Schmerz. 2014 Jun 1; 28 (3): 300-4.

BackgroundChronic pelvic pain in women represents a difficult diagnostic and therapeutic problem in the gynecological practice which is always a challenge when dealing with affected women.Gynecological CausesPossible gynecological causes are endometriosis, adhesions and/or pelvic inflammatory disease (PID), pelvic varicosis and ovarian retention syndrome/ovarian remnant syndrome. Other somatic causes are irritable bowel syndrome, bladder pain syndrome, interstitial cystitis and fibromyalgia.Psychosocial FactorsPsychosocial causes contributing to chronic pelvic pain are a high comorbidity with psychological factors, such as anxiety disorders and substance abuse or depression but the influence of social factors is less certain. The association with physical and sexual abuse also remains unclear.Diagnostics And TherapyImportant diagnostic steps are recording the patient history, a gynecological examination and laparoscopy. Multidisciplinary therapeutic approaches are considered to be very promising. Basic psychosomatic care and psychotherapy should be integrated into the therapeutic concept at an early stage.

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