Authors' objectives: The Vanderbilt Evidence-based Practice Center systematically reviewed evidence on therapies for women age 18 and over with noncyclic chronic pelvic pain (CPP). We focused on the prevalence of conditions thought to occur commonly with CPP; changes in pain, functional status, quality of life, and patient satisfaction resulting from surgical and nonsurgical treatment approaches; harms of nonsurgical approaches; evidence for differences in surgical outcomes if an etiology for CPP is identified postsurgery; and evidence for selecting one intervention over another after an approach fails.

Authors' recommendations: Improved characterization of the targeted condition, intervention, and population in CPP research is necessary to inform treatment choices for this commonly reported entity. A uniform definition of CPP and standardized evaluation of participants are lacking across the literature. Study populations likely vary widely, and studies may be reporting effects from treating symptoms rather than a diagnosed condition. Thus our understanding of potential treatment effects is diluted. Similarly, understanding comorbidity prevalence with CPP is difficult, as conditions may be considered part of the differential diagnosis or a concomitant condition. Among studies addressing treatment effects, little evidence demonstrates the effectiveness of surgical approaches. Studies of nonsurgical approaches typically addressed hormonal management of endometriosis-related CPP and were not placebo controlled, thus limiting our ability to understand whether hormonal therapies would be beneficial for women with CPP without endometriosis and whether pain relief is due simply to the placebo effect. Some studies reported benefits of other nonsurgical approaches, but nonhormonal and nonpharmacologic management remain understudied.

Project Status: Completed

Year Published: 2012

URL for published report: http://effectivehealthcare.ahrq.gov/ehc/products/195/808/CER41-Pelvic-Pain_20120112.pdf

URL for additional information: http://effectivehealthcare.ahrq.gov/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=808

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)