Ultrasound-guided blocks for pelvic pain

Abstract

Chronic pelvic pain (CPP) is defined as noncylic pain of at least 6 months duration, severe enough to cause disability or seek medical attention, occurring in locations such as the pelvis, anterior abdominal wall at or below the umbilicus, lower back, or buttocks. The pathophysiology of CPP is complex. The pain generator may include the viscera (e.g., bladder, bowel), neuromuscular system (e.g., pudendal neuralgia, piriformis syndrome), or the gynecological system (e.g., endometriosis). Pathophysiological processes, both peripherally and centrally combined with psychological factors most likely contribute to the clinical picture. Therefore, a multidisciplinary approach to management is recommended. As part of this management plan, neural blockade and injection of muscles within the pelvis play both a diagnostic and therapeutic role. © 2011 Springer Science+Business Media, LLC.