Ebook ABC of medically unexplained symptoms: Part 2

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Ebook ABC of medically unexplained symptoms: Part 2

CHAPTER 10Pelvic and Reproductive System SymptomsNur Amalina CheBakri1, Camille Busby-Earle2, Robby Steel2 atul Andrew IV. Home11MRC Centre tor Reprod

Ebook ABC of medically unexplained symptoms: Part 2ductive I lcalth, University of Edinburgh. Edinburgh. UK-Simpson Centre for Reproductive Health, Royal Infirinaiy of Edinburgh. Edinburgh. UK’Departme

nt of Psychological Medicine. Royal Infirmary ot Edinburgh. Edinburgh, UKOVERVIEW•>'i0% cjJ (Uitx-nt*. with chtcxik pdvk |M"rt (CPP) IhM* no otmojs un Ebook ABC of medically unexplained symptoms: Part 2

darfytnq pathology•Thr dUgnmkof turnIiuisii CP? should lx’ rjiwri .!•. .1 |XZ. live statement rot an expression of negative findings•Central •xeiũtb.i

Ebook ABC of medically unexplained symptoms: Part 2

tiíxi plays .Ill iir «::• I'xpliirird rate hilly•VuhodfTna and d/spareunta are commonly associated wth CIVIntrod

CHAPTER 10Pelvic and Reproductive System SymptomsNur Amalina CheBakri1, Camille Busby-Earle2, Robby Steel2 atul Andrew IV. Home11MRC Centre tor Reprod

Ebook ABC of medically unexplained symptoms: Part 2nic" or ’functional" it is important to recognise that those overlap: many women will have luilh or^inic: pathology and fimclirmal symptoms.Chronic pe

lvic painGPP is defined as an inlennillenl or constant pain in the lower abdomen or pelvis of at least 6 months" duration, not occurring exclusively w Ebook ABC of medically unexplained symptoms: Part 2

ith menstruation or intercourse and not associated with pregnancy, lhal causes functional disability or limits daily activitiesEpidemiology in primary

Ebook ABC of medically unexplained symptoms: Part 2

careCPP affects 38 per 1000 women in general practice in the UK, which makes ii as common as asthma or hack pain. Patients with CPP make up approxima

CHAPTER 10Pelvic and Reproductive System SymptomsNur Amalina CheBakri1, Camille Busby-Earle2, Robby Steel2 atul Andrew IV. Home11MRC Centre tor Reprod

Ebook ABC of medically unexplained symptoms: Part 2 associated with gynaecological conditions, such as endometriosis, and non-gynaecological conditions such as IBS, interstitial cyslitis/hladder pain s

yndrome, musculoskeletal pain and fibromyalgia In more than 5<1% of pattents, no cause tor the painful symptoms can be found.■1BC «/Air áiõiUy Untụnki Ebook ABC of medically unexplained symptoms: Part 2

-Kd Symfttmf. Elm Edition.Edited by Christopher burton.fit 2013 Idin Wiley & Sons. Ltd. Published 2013 by lolin Wiey & Sons. Ltd.A history of abuse (p

Ebook ABC of medically unexplained symptoms: Part 2

hysical, sexual and/or psychological) is more common in women with GPP.GP assessmentThe aim of GP assessment in women with CPP is to exclude pathologi

CHAPTER 10Pelvic and Reproductive System SymptomsNur Amalina CheBakri1, Camille Busby-Earle2, Robby Steel2 atul Andrew IV. Home11MRC Centre tor Reprod

Ebook ABC of medically unexplained symptoms: Part 2 that only selected patients are referred Io seumdary care.Typical features of organic symptomsEndometriosis is found in 35 50% women with CPP. Cyclic

al pelvic pain (often asMxiated wilhdyMrienorrlioeaanddyspn rennin) in women of reproductive age is the most common symptom associated with the condit Ebook ABC of medically unexplained symptoms: Part 2

ion ami merits referral In secondary care for investigation (sec Box 10.1). The gold standard for diagnosing endometriosis is laparoscopy-. there are

Ebook ABC of medically unexplained symptoms: Part 2

no serum or urinary biomarkers of endometriosis. However, treatment of endometriosis, using drugs that cause ovarian suppression (c.g. combined oral c

CHAPTER 10Pelvic and Reproductive System SymptomsNur Amalina CheBakri1, Camille Busby-Earle2, Robby Steel2 atul Andrew IV. Home11MRC Centre tor Reprod

Ebook ABC of medically unexplained symptoms: Part 2 symptoms, a lajKiroscojry is nut always necessary.Box 10 1 Symptoms indicating possible endometriosis•se'.ece dVimenorhcea•Drift d)-<:.xrur«.i. Chron

ic pehw pain•OvuVition pan•Other cydKá or penmenstrual symptoms, e.q bcwel or bladder. infertility. Dyvhr/U (pain on drlarvatkxi)Adenomyosis is charac Ebook ABC of medically unexplained symptoms: Part 2

terised by the same symptoms as endometriosis. It is more often diagnosed histologically following a hysterectomy but can be diagnosed by pelvic MRI.

Ebook ABC of medically unexplained symptoms: Part 2

Adhesions due to previous surgery, pelvic infection or endometriosis are also associated with CPF but there is little evidence that division of adhesi

CHAPTER 10Pelvic and Reproductive System SymptomsNur Amalina CheBakri1, Camille Busby-Earle2, Robby Steel2 atul Andrew IV. Home11MRC Centre tor Reprod