Rigi10™ Malleable Penile Prosthesis
Also Known As
Chronic pelvic pain syndrome (CPPS), pelvic floor dysfunction, chronic pelvic pain disorder, persistent pelvic pain, pelvic floor tension myalgia, chronic regional pelvic pain syndrome, visceral pelvic pain syndrome
Definition
Pelvic pain is a persistent, disabling, or intermittent discomfort occurring in the lower abdomen or pelvis, between the bellybutton and the hips, that can be acute (sudden and severe) or chronic (lasting six months or longer).1 This complex condition can affect all sexes, though it is more commonly reported in women, and may stem from various sources including reproductive organs, urinary tract, digestive system, musculoskeletal structures, or neurological pathways.2 Chronic pelvic pain is often associated with central sensitization, where the nervous system becomes overly sensitive to pain stimuli, leading to hyperalgesia (increased pain sensitivity) and allodynia (pain from normally non-painful stimuli).3 The condition may exist as a primary disorder or secondary to underlying pathologies, significantly impacting quality of life through physical limitations, psychological distress, and social consequences.4
Clinical Context
Pelvic pain presents in diverse clinical scenarios, requiring comprehensive evaluation to determine appropriate management strategies. Clinically, it is categorized as either acute (sudden onset, often requiring urgent attention) or chronic (persisting for six months or longer).1
Patient selection for evaluation typically includes individuals reporting persistent lower abdominal or pelvic discomfort that impacts daily functioning. The diagnostic approach involves a thorough history and physical examination, including digital rectal examination and assessment for cutaneous allodynia.3 Imaging and laboratory tests may help identify contributing comorbidities, though they are often inconclusive in approximately 50% of cases.3
Common comorbid conditions requiring clinical consideration include endometriosis, irritable bowel syndrome (IBS), interstitial cystitis, pelvic inflammatory disease, musculoskeletal disorders (including pelvic floor dysfunction), and psychological factors such as depression, anxiety, and post-traumatic stress disorder.2 The significant overlap with psychological conditions necessitates a biopsychosocial approach to assessment and treatment.2
Management focuses on symptom relief and addressing physical and psychological contributors. First-line treatments often include nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen, with hormonal therapies beneficial for cyclical pain.3 Neuropathic pain may respond to antidepressants or anticonvulsants, while adjunct therapies such as cognitive behavioral therapy, pelvic floor therapy, and mindfulness techniques have shown efficacy.3 For refractory cases, interventional procedures or surgery may be considered, though outcomes vary widely depending on the underlying cause and individual response to treatment.4