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29 - Pelvic pain, ovarian cysts and endometriosis in adolescent girls

from Part III - Management of specific disorders

Published online by Cambridge University Press:  04 May 2010

By
Paul L. Wood
Edited by
Adam H. Balen ,
Sarah M. Creighton ,
Melanie C. Davies ,
Jane MacDougall  and
Richard Stanhope
Paul L. Wood
Affiliation:
Kettering General Hospital, Kettering, UK
Adam H. Balen
Affiliation:
Leeds Teaching Hospitals, University Trust
Sarah M. Creighton
Affiliation:
University College London Hospitals
Melanie C. Davies
Affiliation:
University College London
Jane MacDougall
Affiliation:
Addenbrooke's Hospital, Cambridge
Richard Stanhope
Affiliation:
Great Ormond Street Hospital
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Summary

Introduction

The legacy of pelvic pathology and pelvic pain in adolescence is not inconsiderable in later life, with ramifications from both the actual pathological processes and their management. The main negative outcomes include subfertility, adhesion formation and chronic pelvic pain. Although these are in general well-recognized causative implications, the general awareness of their origins in the adolescent period is less well acknowledged. As a result, diagnosis may be delayed or treatment may be inappropriate, with consequent negative long-term outcomes for the individual. The lack of a consensus in the definition of chronic pelvic pain greatly hinders epidemiological studies. However, and despite limited data, the prevalence of chronic pelvic pain in the population appears to be high, with an annual prevalence in primary care in the UK of 38/1000 in women, a rate comparable to asthma (37/1000) and back pain (41/1000) (Zondervan & Barlow, 2000). The significance of two defined causes of pelvic pain in adolescence, endometriosis and ovarian cysts, will be explored first prior to an overall review of pelvic pain in this age group. The subject matter will nevertheless overlap throughout this chapter, given the inevitable close interrelationships that exist between pelvic pain, endometriosis and ovarian cysts. For instance, deep endometriosis, pelvic adhesions and ovarian cystic endometriosis are all independent predictors of pelvic pain (Porpora et al., 1999).

Type
Chapter
Information
Paediatric and Adolescent Gynaecology
A Multidisciplinary Approach
 , pp. 359 - 372
Publisher: Cambridge University Press
Print publication year: 2004

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