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  • Chronic pelvic pain syndrome
  • Levator ani syndrome
  • Urogential pain disorders

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  • 338.4 Chronic pain syndrome
  • Associated medical diagnoses
    • 564.6 Anal spasm
    • 569.42 Anal or rectal pain
    • 595.1 Chronic interstitial cystitis
    • 601.1 Chronic prostatitis
    • 617 Endometriosis
    • 625.0 Dyspareunia
    • 625.5 Pelvic congestion syndrome
    • 625.7 Vulvodynia
    • 625.71 Vulvar vestibulitis
  • Associated Physical Therapy Diagnoses
    • 719.45 Pain in joint, pelvic region and thigh
    • 724.7 Disorders of coccyx
    • 728.2 Muscular wasting and disuse atrophy, not elsewhere classified
    • 728.85 Spasm of muscle
    • 728.89 Other disorders of muscle, ligament, and fascia
    • 729.1 Myalgia and myositis, unspecified
    • 729.2 Neuralgia, neuritis, and radiculitis, unspecified
    • 729.9 Other and unspecified disorders of soft tissue
    • 780.7 Malaise and fatigue
    • 782.3 Edema

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  • G89.4 Chronic pain syndrome
  • N30.10 Interstitial cystitis (chronic) without hematuria
  • N30.11 Interstitial cystitis (chronic) with hematuria
  • N41.1 Chronic prostatitis
  • N80 Endometriosis
  • R10.2 Pelvic and perineal pain
  • Symptom specific diagnoses
    • K59.4 Anal spasm
    • N53.12 Painful ejaculation
    • N94.1 Dyspareunia
    • N94.81 Vulvodynia
    • N94.810 Vulvar vestibulitis
    • N94.818 Other vulvodynia
    • N94.819 Vulvodynia unspecified
    • N94.89 Other condition associated with female genital organs and menstrual cycle

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Description2

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  • Defined by a process of exclusion
  • Non-specific, poorly localized pelvic pain or regional pelvic pain syndrome without obvious pathology
  • No evidence of infection or inflammation
  • Chronic urogential pain syndromes often associated with end organ pain conditions (such as bladder, vulva) and psychological conditions (such as emotional, sexual, behavioral)
  • Genitourinary pain syndromes are all chronic in their nature
  • Pain is the major complaint but concomitant complaints include lower urinary tract, bowels, or are sometimes sexual or gynecological in nature3

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Essentials of Diagnosis

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  • Unknown etiology
  • Rule out end organ pathology
  • Symptoms may be initiated by an acute infection, injury, or inflammation of a pelvic or urogential organ, however pain persists beyond the duration of the original inciting event or disease

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General Considerations

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  • Chronic pain condition
  • Often misdiagnosed
  • PT intervention is often appropriate for associated musculoskeletal impairments
  • Diagnosis is a process of exclusion and often takes time, requiring intensive diagnostic testing
  • Urogenital pain disorders frequently affect nearby body areas; especially back, pelvic, hip, and groin regions and so may be inappropriately referred to PT
  • May mimic other visceral pain conditions including colon cancer or tumors, irritable bowels, colitis
  • May mimic gynecologic problems in females: endometriosis, uterine fibroids, ectopic pregnancy

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Demographics

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  • More prevalent in females
  • Exact prevalence of chronic pelvic pain is not known, estimates vary in the literature from 3.8% to 24%4
  • Of the estimated 10 million women with chronic pelvic pain, less than 70% will receive proper diagnosis and treatment plans and 61% ...

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