Chronic pelvic pain has two different definitions:
Chronic pelvic pain as defined by gynecologists’ (ACOG) applies to women only.
Chronic pelvic pain as defined by urologists’ (EAU) includes both women and men.
The European Association of Urologists (EAU) guidelines distinguish between gynecological, gastrointestinal and musculoskeletal pain syndromes.
ACOG’s Definition of Chronic Pelvic Pain
The American College of Obstetricians and Gynecologists (ACOG) includes only women in its definition of chronic pelvic pain.
ACOG defines chronic pelvic pain as follows (Ref. 2011):
“Pain lasting for six or more months that localizes to the anatomic pelvis, anterior abdominal wall at or below the umbilicus, the lumbosacral back, or the buttocks and is of sufficient severity to cause functional disability or lead to medical care. Chronic pain can come and go or it can be constant.” (1)
Chronic Pelvic Pain Continues after a Hysterectomy
Berek, J., “Novak’s Textbook of Gynecology”; 12th ed., 1996 lists the following statistic (2):
“Approximately 12 percent of hysterectomies are performed for pelvic pain and 30 percent of patients who seek treatment at pain clinics have already had a hysterectomy.” (2)
EAU’s Definition of Chronic Pelvic Pain
The European Association of Urology (EAU) includes both women and men in its definition of chronic pelvic pain.
The European Association of Urology (EAU) defines chronic pelvic pain as follows (Ref. 2013):
“Chronic or persistent pain perceived in structures related to the pelvis of either men or women. The pain must be continuous or recurrent for at least six months.” (3)
Urological Pain Syndromes-Women / Men
When the pain is localized to a single organ, some specialists may wish to consider using an end organ term such as “Bladder Pain Syndrome.”
Urological pain syndromes include bladder pain syndrome, which is often termed as interstitial cystitis.
Urological Pain Syndromes in Men
Urological pain syndromes in men include Prostate Pain Syndrome, which is often termed Chronic Prostatitis /Chronic Pelvic Pain Syndrome according to the NIH classification of chronic prostatitis.
Chronic Prostatitis/Chronic Pelvic Pain Syndrome
Many researchers use the term Chronic Prostatitis/Chronic Pelvic Pain Syndrome according to the National Institute of Health (NIH) classification of chronic prostatitis.
Chronic Pelvic Pain Syndrome (CPPS)
When the pain is localized to more than one organ site, the term Chronic Pelvic Pain Syndrome (CPPS) should be used.
Chronic Pelvic Pain Syndrome(s) (CPPS) in Women
In women, Chronic Pelvic Pain Syndrome (CPPS) includes the following:
- Vulvar Pain Syndrome (a/k/a vulvodynia)
- Vestibular Pain Syndrome
- Clitoral Pain Syndrome
- Associated Pain Syndrome
- Irritable Bowel Syndrome
- Pelvic Floor Muscle Pain Syndrome
Most Common Pain Syndrome in Women
The most common musculoskeletal pain syndrome in women is pelvic floor muscle pain syndrome.
Chronic Pelvic Pain Syndrome(s) (CPPS) in Men
In men, Chronic Pelvic Pain Syndrome (CPPS) includes the following urological pain syndromes:
- Scrotal Pain Syndrome
- Testicular Pain Syndrome
- Epididymal Pain Syndrome Post Vasectomy Scrotal Pain Syndrome
- Penile Pain Syndrome
- Urethral Pain Syndrome
Many research articles refer to the above-mentioned CPPS syndromes as:
- chronic orchialgia or
- chronic scrotal syndrome
Most Common Pain Syndromes in Men
Prostate Pain Syndrome/Chronic Prostatitis and Chronic scrotal pain/chronic orchialgia are the most common syndromes male patients complain of.
- The American College of Obstetricians and Gynecologists (ACOG 2011);
- Berek, J., “Novak’s Textbook of Gynecology”; 12th ed., 1996;
- European Association of Urology (EAU 2017).