Recently, there has been an explosion of research into endometriosis associated pain and the influence of central mechanisms in the pain experience. Endometriosis-associated pain syndrome (EAP) is defined as “chronic or recurrent pelvic pain in patients with laparoscopically confirmed endometriosis”, and the term is used when the symptoms persist despite adequate endometriosis treatment.1

Real time 2D transperineal ultrasound imaging is emerging as an exciting technique for both pelvic floor muscle assessment and training.  Far superior to the transabdominal approach, it’s a valuable tool to use with patients before or after radical prostatectomy, prolapse, pelvic pain, obstructed defecation, or voiding dysfunction.

Tracey was referred to Pelvic Health Matters with dyspareunia, vulvodynia, and pelvic floor muscle dysfunction following gynaecological surgery.  This case study explores the impact of psychological and social factors on Tracey’s pain experience. It highlights the importance of following a biopsychosocial approach incorporating therapeutic neuroscience concepts when developing an effective treatment program.

The research is now undeniable - educating a patient about the science of pain is an essential component of persistent pain care.  Unfortunately, pain education is not easy and finding the right language is challenging for many health professionals.

According to the 2022 European Association of Urology Guidelines on Chronic Pelvic Pain, Persistent Pelvic Pain (PPP) is persistent pain perceived in structures related to the pelvis of either men or women1.  PPP can be further categorised as Chronic Primary Pelvic Pain, where there is no obvious pathology and Chronic Secondary Pelvic Pain, where there is specific disease or pathology associated pelvic pain1.  For both categories, pain must have been continuous or recurrent for at least 3 months or have been in a cyclical pattern for at least 6 months.