Skip to main content

Adenomyosis, Leiomyomata, and Pelvic Pain

  • Chapter
Chronic Pelvic Pain
  • 149 Accesses

Abstract

Chronic pelvic pain can present either cyclically or noncyclically. Causes of cyclic pelvic pain include dysmenorrhea, endometriosis, and adenomyosis,1 whereas noncyclical causes include endometriosis, adenomyosis, leiomyomata, pelvic adhesive disease, and gastrointestinal disorders. In this chapter we will discuss the prevalence, etiology, diagnosis, and treatment of adenomyosis and leiomyomata as causes of pelvic pain.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

References

  1. Muse KN. Cyclic pelvic pain. [Review]. Obstet Gynecol Clin North Am 1990; 17: 427–40.

    PubMed  CAS  Google Scholar 

  2. Azziz R. Adenomyosis: current perspectives. Obstet Gynecol Clin North Am 1989; 16: 221–35.

    PubMed  CAS  Google Scholar 

  3. Owolabi TO, Strickler RC. Adenomyosis: a neglected diagnosis. Obstet Gynecol 1977; 50: 424–27.

    PubMed  CAS  Google Scholar 

  4. Gautier C, Solmon F, Maillet R, et al. [Uterine adenomyosis (author’ s transi.)]. [French]. Nouvelle Presse Medicale 1977; 6: 3621–23.

    PubMed  CAS  Google Scholar 

  5. Bird CC, Mcelin TW, Manalo-Estrella R The elusive adenomyosis of the uterusrevisited. Am J Obstet Gynecol 1972; 112: 583–93.

    PubMed  CAS  Google Scholar 

  6. Halvorsen TB, Moen MH. The extent and clinical significance of adenomyotic lesions in the uterine wall. A quantitative assessment. APMIS 1993; 101: 907–13.

    CAS  Google Scholar 

  7. van der Walt LA, Sanfilippo JS, Siegel JE, et al. Estrogen and progestin receptors in human uterus: reference ranges of clinical conditions. Clin Physiol Biochem 1986; 4: 217–28.

    PubMed  Google Scholar 

  8. Azziz R. Adenomyosis in pregnancy. A review. J Reproduct Med 1986; 31: 224–27.

    CAS  Google Scholar 

  9. Donnez J, Nisolle M, Casanas-Roux F, et al. Rectovaginal septum, endometriosis or adenomyosis: laparoscopic management in a series of 231 patients. Hum Reprod 1995; 10: 630–35.

    PubMed  CAS  Google Scholar 

  10. Koninckx PR, Martin DC. Deep endometriosis: a consequence of infiltration or retraction or possibly adenomyosis externa? [see comments]. Fertil Steril 1992; 58: 924–28.

    PubMed  CAS  Google Scholar 

  11. Novak ER, Woodruff JD, eds. Gynecologic and obstetric pathology. Philadelphia: WBSaunders, 1979 p 260.

    Google Scholar 

  12. Young RH, Treger T, Scully RE. Atypical polypoid adenomyoma of the uterus. A report of 27 cases. Am J Clin Pathol 1986; 86: 139–45.

    PubMed  CAS  Google Scholar 

  13. Mori T, Singtripop T, Kawashima S. Animal model of uterine adenomyosis: is prolactin a potent inducer of adenomyosis in mice? [Review]. Am J Obstet Gynecol 1991; 165: 232–34.

    PubMed  CAS  Google Scholar 

  14. Lewinski H, Emge LA. The elusive adenomyosis of the uterus. Am J Obstet Gynecol 1962; 83: 1541–46.

    Google Scholar 

  15. Morris H. Surgical pathology of the lower uterine segment caesarean section scar: is the scar a source of clinical symptoms? Int J Gynecol Pathol 1995; 14: 16–20.

    Article  PubMed  CAS  Google Scholar 

  16. Lee NC, Dicker RC, Rubin GL, et al. Confirmation of the preoperative diagnoses for hysterectomy. Am J Obstet Gynecol 1984; 150: 283–87.

    PubMed  CAS  Google Scholar 

  17. Stovall TG, Ling FW, Crawford DA. Hysterectomy for chronic pelvic pain of presumed uterine etiology [see comments]. Obstet Gynecol 1990; 75: 676–79.

    PubMed  CAS  Google Scholar 

  18. Benson RC, Sneeden VD. Adenomyosis: a reappraisal of symptomology. Am J Obstet Gynecol 1958; 76: 1044–61.

    PubMed  CAS  Google Scholar 

  19. Kilkku P, Erkkola R, Gronroos M. Non-specificity of symptoms related to adenomyosis. A prospective comparative survey. Acta Obstet Gynecol Scand 1984; 63: 229–31.

    Article  PubMed  CAS  Google Scholar 

  20. Molitor JJ. Adenomyosis: a clinical and pathologic appraisal. Am J Obstet Gynecol 1971; 1971: 275–84.

    Google Scholar 

  21. Isreal SL, Woutersz TB. Adenomyosis: a neglected diagnosis. Obstet Gynecol 1959; 168–73.

    Google Scholar 

  22. McCausland AM. Hysteroscopic myometrial biopsy: its use in diagnosing adenomyosis and its clinical application. Am J Obstet Gynecol 1992; 166: 1619–26; discussion 1626.

    PubMed  CAS  Google Scholar 

  23. Nelson JR, Corson SL. Long-term management of adenomyosis with a gonadotro-pin-releasing hormone agonist: a case report. Fertil Steril 1993; 59: 441–43.

    PubMed  CAS  Google Scholar 

  24. Bohlman ME, Ensor RE, Sanders RC. Sonographic findings in adenomyosis of the uterus. Am J Roentgenol 1987; 148: 765–66.

    CAS  Google Scholar 

  25. Fedele L, Bianchi S, Dorta M, et al. Transvaginal ultrasonography in the diagnosis of diffuse adenomyosis. Fertil Steril 1992; 58: 94–97.

    PubMed  CAS  Google Scholar 

  26. Walsh JW, Tayloer KJW, Rosenfield AT. Gray scale ultrasonography in the diagnosis of endometriosis and adenomyosis. ARJ 1979; 132: 87–90.

    CAS  Google Scholar 

  27. Winfield SL, Wentz AC, Winfield AL, Wentz AC, eds. Diagnostic imaging in infertility, second ed. Williams & Wilkins, Baltimore 1992; pp 39–56.

    Google Scholar 

  28. Kokcu A, Alvur Y, Baris YS, et al. Leiomyomatous peritonealis dissemination. Acta Obstet Gynecol Scand 1994; 73: 81–83.

    Article  PubMed  CAS  Google Scholar 

  29. Togashi K, Ozasa I, Konishi I, et al. Enlarged uterus: differentiation between adenomyosis and leiomyoma with MR imaging. Radiology 1989; 171: 531–34.

    PubMed  CAS  Google Scholar 

  30. Ascher SM, Arnold LL, Patt RH, et al. Adenomyosis: prospective comparison of MR imaging and transvaginal sonography. Radiology 1994; 190: 803–806.

    PubMed  CAS  Google Scholar 

  31. Togashi K, Itoh H, Fujisawa F, et al. Adenomyosis: diagnosis with MRI imaging. Radiology 1988; 166: 111–14.

    PubMed  CAS  Google Scholar 

  32. Moreno AJ, Pacheco EJ, Carpenter AL, et al. Adenomyosis as seen on blood flow and blood pool imaging during bone scintigraphy. Clin Nucl Med 1994; 19: 204–206.

    Article  PubMed  CAS  Google Scholar 

  33. Popp LW, Schwiedessen JP, Gaetje R. Myometrial biopsy in the diagnosis of adenomyosis uteri. Am J Obstet Gynecol 1993; 169: 546–49.

    PubMed  CAS  Google Scholar 

  34. Langebrekke A, Skar OJ, Urnes A. Laparoscopic hysterectomy. Initial experience. Acta Obstet Gynecol Scand 1992; 71: 226–29.

    Article  CAS  Google Scholar 

  35. Wortman M, Dagget A. Hysteroscopic endomyometrial resection: a new technique for the treatment of menorrhagia. Obstet Gynecol 1994; 83: 295–98.

    PubMed  CAS  Google Scholar 

  36. Yuen PM. Adenomyosis following endometrial rollerball ablation. Aust N Z J Obstet Gynaecol 1995; 39: 207–11.

    Google Scholar 

  37. Wood C, Maher P, Hill D. Biopsy diagnosis and conservatice surgical treatment of adenomyosis. Aust N Z J Obstet Gynaecol 1993; 33: 319–21.

    Article  PubMed  CAS  Google Scholar 

  38. Grow DR, Filer RB. Treatment of adenomyosis with long-term GnRH analogues: a case report. Obstet Gynecol 1991; 78: 538–39.

    PubMed  CAS  Google Scholar 

  39. Hirata JD, Moghissi KS, Ginsburg KA. Pregnancy after medical therapy of adenomyosis with a gonadotropin-releasing hormone agonist. Fertil Steril 1993; 59: 444–45.

    PubMed  CAS  Google Scholar 

  40. Silva PD, Perkins HE, Schauberger CW. Live birth after treatment of severe adenomyosis with a gonadotropin-releasing hormone agonist. Fertil Steril 1994; 61: 171–72.

    PubMed  CAS  Google Scholar 

  41. Igarashi M. Anew therapy for pelvic endometriosis and uterine adenomyosis: local effect of vaginal and intrauterine danazol application. Asia Oceania J Obstet Gynecol 1990; 16: 1–12.

    Article  CAS  Google Scholar 

  42. Takebayashi T, Fujino Y, Umesaki N, et al. Danazol suspension injected into the uterine cervix of patients with adenomyosis and myoma. Gynecol Obstet Invest 1995; 39: 207–11.

    Article  PubMed  CAS  Google Scholar 

  43. Fejzo MS. Yoon SJ, Montgomery KT, et al. Identification of a YAC spanning the translocation breakpoints in uterine leiomyomata, pulmonary chondroid hamartona, and lipoma: physical mapping of the 12q 14-q 15 breakpoint region in uterine leiomyomata. Genomics 1995; 26: 265–71.

    Article  PubMed  CAS  Google Scholar 

  44. Cramer DW. Epidemiology of myomas. Semin Reprod Endocrinol 1992; 10: 320–24.

    Article  Google Scholar 

  45. Lev-Toaff AS, Coleman BG, Arger PH, et al. Leiomyomas in pregnancy: sonographic study. Radiology 1987; 164: 375–80.

    PubMed  CAS  Google Scholar 

  46. Zaloudek C, Norris HC, Kurman RJ, eds. Mesenchymal tumors of the uterus. In Blaustein’s Pathology of the Female Genital Tract. Third ed. Springer-Verlag, New York 1987; 13: 373–408.

    Google Scholar 

  47. Larsson G. Multiple leiomyomata of the urinary bladder in a hysterectomized woman [see comments]. Acta Obstet Gynecol Scand 1994; 73: 78–80.

    Article  PubMed  CAS  Google Scholar 

  48. Persaud V, Arjoon PD. Uterine leiomyomata. Incidence of degenerative change and a correlation of associated symptoms. Obstet Gynecol 1970; 35: 432–36.

    CAS  Google Scholar 

  49. Ferencyzy A, Richart RM, Okagaki T. A comparative ultrastructural study of leiomyosarcoma, cellular leiomyoma and leiomyoma of the uterus. Cancer 1971; 28: 1004–18.

    Article  Google Scholar 

  50. Zaloúdek CJ, Norris HJ, Fenoglio CM, eds. Mesenchymal tumors of the uterus. In Progress in Surgical Pathology. Masson Publishing, New York, 1981; 1: 1–35.

    Google Scholar 

  51. Linder D, Gartier SM. Glucose-6-phospate dehydrogenase mosaicism: utilization as a cell marker in the study of leiomyomatas. Science 1965; 150: 67–69.

    Article  PubMed  CAS  Google Scholar 

  52. Townsend DE, Sparkes RS, Baluda MC, et al. Unicellular histogenesis of uterine leimyomatas as determined by electrophoresis by glucose-6-phoshate dehydrogenase. Am J Obstet Gynecol 1970; 1168–73.

    Google Scholar 

  53. Vogelstein B, Fearon ER, Hamilton SR, et al. Clonal analysis using recobinant DNA probes from the X chromosome. Cancer Res 1987; 47: 4806–13.

    PubMed  CAS  Google Scholar 

  54. Wong IL, Nelson LM, Ward K. Uterine leiomyomata are clonal tumors as determined by an X chromosome methylation sensitive DNA polymorphism. 39th Annual Meeting of the Society for Gynecologic Investigation, San Antonio, TX(\ 992) [Abstract]

    Google Scholar 

  55. Soules MR, McCarty Jr. KS. Leiomyomas: steroid receptor contant. Variation in normal menstrual cycles. Am J Obstet Gynecol 1982; 143: 6–11.

    PubMed  CAS  Google Scholar 

  56. Tamaya T, Fujimoto J, Okada H. Comparision of cellular levels of steriod receptors in uterine leiomyoma in myometrium. Acta Obstet Gynecol Scand 1985; 64: 307–309.

    Article  PubMed  CAS  Google Scholar 

  57. Wilson EA, Yang F, Rees ED. Estradiol and progesterone binding in uterine leiomyomata and in normal tissues. Obstet Gynecol 1980; 55: 20–24.

    PubMed  CAS  Google Scholar 

  58. Hasan F, Arumugam K, Sivanesaratnam V. Uterine leiomyomata in pregnancy. Int J Gynecol Pathol 1991; 34: 45–48.

    CAS  Google Scholar 

  59. Hutchins FL, Jr. Uterine fibroids: diagnosis and indications for treatment [review]. Obstet Gynecol Clin N Am 1995; 22: 659–65.

    Google Scholar 

  60. Winer-Muran HT, Muran D, Gillieson MS. Uterine myomatas in pregnancy. Can MedAssoc J 1983; 128: 949–50.

    Google Scholar 

  61. Buttram VC Jr., Reiter RC. Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril 1981; 36: 433–45.

    PubMed  Google Scholar 

  62. Watanabe Y, Nakamura G. Effects of two different doses of leuprolide acetate depot on uterine cavity area in patients with uterine leiomyomata. Fertil Steril 1995; 63: 487–90.

    PubMed  CAS  Google Scholar 

  63. Friedman AJ, Lobel SM, Rein MS, et al. Efficacy and safety considerations in women with leiomyomas treated with gonadotropin releasing hormone agonists: the estrogen threshold hypothesis. Am J Obstet Gynecol 1990; 163: 1114–19.

    PubMed  CAS  Google Scholar 

  64. Sener AB, Seckin NC, Ozmen S, et al. The effects of hormone replacement therapy on uterine fibroids in postmenopausal women. Fertil Steril 1996; 65: 354–57.

    PubMed  CAS  Google Scholar 

  65. Fraser IS, McCarron G, Markham R, et al. Measured menstrual blood loss in women with menorrhagia associated with pelvic disease or coagulation disorder. Obstet Gynecol 1986; 69: 630–33.

    Google Scholar 

  66. Phelan JP. Myomas and pregnancy. Obstet Gynecol Clin North Am 1995; 22: 801–805.

    PubMed  CAS  Google Scholar 

  67. Winer-Muram HT, Muran D, Gillieson MS. Uterine myomas in pregnancy. J Assoc Can Radio 11984; 35: 168–76.

    CAS  Google Scholar 

  68. Sherer DM, Edgar DM, Pulli GJ, et al. Pedunculated uterine fibroid simulating an incarcerated inguinal hernia in pregnancy. Am J Obstet Gynecol 1994; 170: 724–25.

    PubMed  CAS  Google Scholar 

  69. Reiter RC, Wagner PL, Gambone JC. Routine hysterectomy for large asyptomatic leiomyoma: a reappraisal. Obstet Gynecol 1992; 79: 481–84.

    PubMed  CAS  Google Scholar 

  70. Friedman AJ, Haas ST. Should uterine size be an indication for surgical intervention in women with myomas? [see comments] [review]. Am J Obstet Gynecol 1993; 168: Pt. 1: 751–55.

    PubMed  CAS  Google Scholar 

  71. Winfield SL, Wentz AC, Winfield AL, eds. The uterine cavity. In Diagnostic Imaging in Infertility. 2nd ed. Williams & Wilkins, Baltimore, 1992; 6: 96–115.

    Google Scholar 

  72. Parker WH, Fu YS, Berek JS. Uterine sarcoma in patients operated on for presumed leiomyoma and rapidly growing myoma. Obstet Gynecol 1994; 83: 414–18.

    PubMed  CAS  Google Scholar 

  73. Carlson KJ, Miller BA, Fowler FJ. The Maine Women’ s Health Study II. Outcomes of nonsurgical management of leiomyomas, abnormal bleeding, and chronic pelvic pain. Obstet Gynecol 1994; 83: 566–72.

    CAS  Google Scholar 

  74. Makarainen L, Ylikorkala O. Primary and myoma-associated menorrhagia: ole of prostoglandins and effects of ibuprofen. Br J Obstet Gynaecol 1986; 93: 974–78.

    Article  PubMed  CAS  Google Scholar 

  75. Katz V, Dotters DJ, Droegemueller W. Complications of uterine leiomyomas in pregnancy. Obstet Gynecol 1989; 73: 593–96.

    PubMed  CAS  Google Scholar 

  76. Friedman AJ, Thomas PP. Does low-dose combination oral contraceptive use affect uterine size or menstrual flow in premenopausal women with leiomyomas? Obstet Gynecol 1995; 85: 631–35.

    Article  PubMed  CAS  Google Scholar 

  77. Rozenbaum H. Traitement medical des fibromes uterins par les progestatifs du groups nor-pregnane. Gynecologie 1989; 40: 175–79.

    Google Scholar 

  78. Corson SL, Brooks PG. Resectoscopic myomectomy. Fertil Steril 1991; 55: 1041–44.

    PubMed  CAS  Google Scholar 

  79. Stovall TG. Gonadotropin-releasing hormone agonists: utilization before hysterectomy [review]. Clin Obstet Gynecol 1993; 36: 642–49.

    Article  PubMed  CAS  Google Scholar 

  80. Jourdain O, Roux D, Cambon D, et al. Anew method for the treatment of fibromas: interstitial laser hyperthermia using the nd: yag laser, preliminary study. Eur J Obstet Gynecol Reprod Biol 1996; 64: 73–78.

    Article  PubMed  CAS  Google Scholar 

  81. Reinsch RC, Murphy AA, Morales AJ, et al. The effects of RU 486 and leuprolide acetate on uterine artery blood flow in the fibroid uterus: a prospective, randomized trial. Am J Obstet Gynecol 1994; 170: 1623–28.

    PubMed  CAS  Google Scholar 

  82. Friedman AJ, Hoffman DI, Comite F, et al. Treatment of leiomyomata uteri with leuprolide acetate depot: a double-blind, placebo controlled, multicenter study. The Leuprolide Study Group. Obstetrics & Gynecology 1991; 77: 720–25.

    CAS  Google Scholar 

  83. Schlaff WD, Zerhouni EA, Huth JA, et al. A placebo-controlled trial of a depot gonadotropin-releasing hormone analogue (Leuprolide) in the treatment of uterine leiomyomata. Obstet Gynecol 1989; 74: 856–62.

    PubMed  CAS  Google Scholar 

  84. Friedman AJ. Use of gonadotropin-releasing hormone agonists before myomectomy [review]. Clin Obstet Gynecol 1993; 36: 650–59.

    Article  PubMed  CAS  Google Scholar 

  85. Scialli AR, Jestila KJ. Sustained benefits of leuprolide acetate with or without subsequent medroxyprogesterone acetate in the nonsurgical management of leiomyomata uteri. Fertil Steril 1995; 64: 313–20.

    PubMed  CAS  Google Scholar 

  86. van Leusden HA. Symptom-free interval after triptorelin treatment of uterine fibroids: long term results. Gynecol Endocrinol 1992; 6: 189–98.

    Article  PubMed  Google Scholar 

  87. Lee WY, Tzeng CC, Chou CY. Uterine leiomyosarcomas coexistent with cellular and atypical leiomyomata in a young woman during the treatment with luterinizing hormone-releasing hormone agonist [review]. Gynecol Oncol 1994; 52: 74–79.

    Article  PubMed  CAS  Google Scholar 

  88. Chipato T, Healy DL, Vollenhoven B, et al. Pelvic pain complicating LHRH analogue treatment of fibroids. Aust N Z J Obstet Gynaecol 1191; 31: 383–84.

    Article  Google Scholar 

  89. Friedman AJ. Treatment of leiomyomata uteri with short-term leuprolide followed by leuprolide plus estrogen-progestin hormone replacement thereapy for 2 years: a pilot study. Fertil Steril 1989; 51: 526–31.

    PubMed  CAS  Google Scholar 

  90. Maheux R, Lemay A. Treatment of peri-menopausal women: potential long-term therapy with a depot GnRH agonist combined with hormonal replacement therapy. Br J Obstet Gynaecol 1992; 99: 13–17.

    PubMed  Google Scholar 

  91. Friedman AJ, Barbieri RL, Doubilet PM, et al. A randomized, double-blind trial of a gonadotropin releasing-hormone agonist (leuprolide) with or without medroxyprogesterone acetate in the treatment of leiomyomata uteri. Fertil Steril 1988; 49: 404–409.

    PubMed  CAS  Google Scholar 

  92. West CP, Lumsden MA, Hillier H, et al. Potential role for medroxyprogesterone acetate as an adjunct to goserelin (Zoladex) in the medical management of uterine fibroids. Hum Rep 1992; 7: 328–32.

    CAS  Google Scholar 

  93. Reich H. Laparoscopic myomectomy [review]. Obstet Gynecol Clin North Am 1995; 22: 757–80.

    PubMed  CAS  Google Scholar 

  94. Goldfarb HA. Laparoscopic coagulation of myoma (myolysis) [review]. Obstet Gynecol Clin North Am 1995; 22: 807–19.

    PubMed  CAS  Google Scholar 

  95. Lev-Toaff AS, Karasick S, Toaff ME. Hysterosalpingography before and after myomectomy: clinical value and imaging findings. AJR 1993; 160: 808–807.

    Google Scholar 

  96. Monk BJ, Berman Ml, Montz FJ. Adhesions after extensive gynecologic surgery: clinical significance, etiology, and prevention. Am J Obstet Gynecol 1994; 170: 1396–1403.

    PubMed  CAS  Google Scholar 

  97. Ray NF, Larsen JW Jr., Stillman RJ, et al. Economic impact of hospitalizations for lower abdominal adhesiolysis in the United States in 1988. Surg Gynecol Obstet 1993; 176: 271–76.

    PubMed  CAS  Google Scholar 

  98. Diamond MP. Reduction of adhesions after uterine myomectomy by Seprafilm membrane (HAL-F: a blinded, prospective, randomized multicenter clinical study. Fertil Steril 1996; 66: 904–10.

    PubMed  CAS  Google Scholar 

  99. Urman B, Gomel V, Jetha N. Effect of hyaluronic acid on postoperative intraperitoneal adhesion formation in the rat model. Fertil Steril 1991; 56: 563–67.

    PubMed  CAS  Google Scholar 

  100. Holmdahl L, Risberg, eds. Adhesions: pathogenesis and prevention.Proceedings of a Symposium held on Jan 19, 1996 in Göteborg, Sweden. Scandinavian University Press, 1997.

    Google Scholar 

  101. Becker JM, Dayton MT, Fazio VW, et al. Prevention of postoperative abdominal adhesions by a sodium hyaluronate based bioresorbable membrane: a prospective, randomized, double-blind multicenter study. J Am Col Surg 1996; 183: 297–306.

    CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1998 Springer Science+Business Media New York

About this chapter

Cite this chapter

Knochenhauer, E., Azziz, R. (1998). Adenomyosis, Leiomyomata, and Pelvic Pain. In: Blackwell, R.E., Olive, D.L. (eds) Chronic Pelvic Pain. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-1752-7_8

Download citation

  • DOI: https://doi.org/10.1007/978-1-4612-1752-7_8

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4612-7265-6

  • Online ISBN: 978-1-4612-1752-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics