Chronic pelvic pain with normal laparoscopic findings.

Abstract

An expectation that pelvic pain should be 'visible' at laparoscopy can leadto disappointment for patients and confusion among health practitioners when no abnormalities are found. This article outlines an approach for understanding, explaining and managing chronic pelvic pain in women with a normal laparoscopy. It divides symptoms into those associated with pelvic organs, pelvic muscles, the central nervous system and psychosocial factors. Management requires considering the origin of the pain, the extent of pelvic muscle reaction to the pain, the severity of central pain sensitisation and additional psychosocial aggravating factors. Considering symptoms within these categories provides a useful framework tobest target therapeutic interventions. Apatient who knows that management of her pain will continue and that an absence of lesions does not diminish the validity of her pain experience can feel confident in herselfand her health practitioner.