New Developments in the Pharmacotherapy of Neuropathic Chronic Pelvic Pain

Abstract

Advancements in further understanding the pathophysiology of chronic pelvic pain syndromes continue to direct therapy. The mechanisms of chronic pelvic pain are often multifactorial and therefore require a multidisciplinary approach. The final treatment plan is often an accumulation of organ-specific treatment and chronic pain medications directed to the CNS and PNS. This article is a review of commonly used medications for chronic pelvic neuropathic pain disorders as well as an introduction to recent innovative developments in pain medicine.

Surgery for deep endometriosis without involvement of digestive or urinary tracts: do not worry the patients!

“…Ovarian endometriomas may be treated by second surgery; however, iterant surgeries negatively impact ovarian reserve and should be limited in women with further pregnancy intention. As regards pelvic hypersensitivity, its mechanisms are incompletely known (21,22), and iterative surgery is useless in a majority of cases.…”

Gabapentin has Longer-Term Efficacy for the Treatment of Chronic Pelvic Pain in Women: A Systematic Review and Pilot Meta-analysis

“…Physical and psychological treatment therapies have been used to manage CPP, albeit with limited success [ 4 – 7 ]. Notably, pharmacotherapy remains the first-line treatment for CPP in women [ 8 , 9 ], with the common analgesic gabapentin increasingly showing potential benefits for CPP patients [ 10 ].…”

The use of alpha‐2‐macroglobulin as a novel treatment for patients with chronic pelvic pain syndrome

“…Chronic pelvic pain syndrome (CPPS), defined as continuous or recurrent pain in the pelvic region lasting at least six months, which cannot be wholly attributed to a single organ or distinct pathology, 1 has a multifactorial etiology involving the gynecologic, urologic, gastrointestinal, musculoskeletal and/or neurologic systems. Aberrant pain signal processing and local tissue responses are contributive factors 2 . Current recommendations for management are multimodal and include physical therapy, pharmacotherapy, cognitive behavioral therapy, and interventional procedures 1…”