Skip to main content

Advertisement

SpringerLink
Log in

Interventional Therapies for Controlling Pelvic Pain: What is the Evidence?

  • Published:
Current Pain and Headache Reports Aims and scope Submit manuscript

Abstract

Chronic pelvic pain (CPP) has many potential causes and is often a complex disorder with multiple contributing etiologies. The evaluation and treatment of women with CPP often requires a multidimensional approach. The treatment of CPP consists of two approaches: 1) treatment of pain itself or global treatment, and 2) treatment of disease-specific etiologies. Most often, treatment requires a combination of both approaches. This article reviews recent literature in the global treatment of CPP, including pharmacologic, psychotherapy, and neuroablative, as well as specific interventions for endometriosis, interstitial cystitis, pelvic adhesive disease, adenomyosis, and pelvic venous congestion.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

  1. Lippman SA, Warner M, Samuels S, et al.: Uterine fibroids and gynecologic pain syndrome in a population-based study. Fertil Steril 2003, 80:1488.

    Article  PubMed  Google Scholar 

  2. Zondervan KT, Yudkin PL, Vessey MP, et al.: Prevalence and incidence of chronic pelvic pain in primary care: evidence from a national general practice database. Br J Obstet Gynaecol 1999, 106:1149.

    CAS  PubMed  Google Scholar 

  3. Grace VM, Zondervan KT: Chronic pelvic pain in New Zealand: prevalence, pain severity, diagnoses and use of health services. Aust N Z J Public Health 2004, 28:369.

    Article  PubMed  Google Scholar 

  4. Mathias SD, Kupperman M, Liberman RF, et al.: Chronic pelvic pain: prevalence, health-related quality of life, and economic correlates. Obstet Gynecol 1996, 87:321.

    Article  CAS  PubMed  Google Scholar 

  5. Farquhar CM, Steiner CA: Hysterectomy rates in the United States 1990–1997. Obstet Gynecol 2002, 99:229.

    Article  PubMed  Google Scholar 

  6. Zondervan KT, Yudkin PL, Vessey MP, et al.: Chronic pelvic pain in the community: symptoms, investigations, and diagnoses. Am J Obstet Gynecol 2001, 184:1149.

    Article  CAS  PubMed  Google Scholar 

  7. Howard F: Chronic pelvic pain. Obstet Gynecol 2003, 101:594–611.

    Article  PubMed  Google Scholar 

  8. •• Kroenke K, Krebs EE, Bair MJ: Pharmacotherapy of chronic pain: a synthesis of recommendations from systematic reviews. Gen Hosp Psychiatry 2009, 31:206–219. This article offers an evidenced-based approach and review of pharmacologic interventions for the treatment of chronic pain. It explores the use of NSAIDs, narcotics, and other alternatives medications, and touches on challenges of chronic narcotic use.

    Article  PubMed  Google Scholar 

  9. Adams EH, Breiner S, Cicero TJ, et al.: A comparison of the abuse liability of tramadol, NSAIDs, and hydrocodone in patients with chronic pain. J Pain Symptom Manage 2006, 31:455–476.

    Article  CAS  Google Scholar 

  10. Chou R, Clark E, Helfand M: Comparative efficacy and safety of long-acting oral opioids for chronic non-cancer pain: a systematic review. J Pain Symptom Manage 2003, 26:1026–1048.

    Article  CAS  PubMed  Google Scholar 

  11. O’Mally PG, Jackson JL, Santoro J, et al.: Antidepressant therapy for unexplained symptoms and symptom syndromes. J Fam Pract 1999, 48:980–990.

    Google Scholar 

  12. Lunn MP, Hughes RA, Wiffen PJ: Duloxetine for treating peripheral neuropathy of chronic pain. Cochrane Database Syst Rev 2009, 7:CD007115.

    Google Scholar 

  13. Brown CS, Franks AS, Wan J, Ling FW: Citalopram in the treatment of women with chronic pelvic pain: an open-label trial. J Reprod Med 2008, 53:191–195.

    CAS  PubMed  Google Scholar 

  14. Bajwa ZH, Simopoulos TT, Pal J, et al.: Low and therapeutic doses of antidepressants are associated with similar response in the context of multimodal treatment of pain. Pain Physician 2009, 12:893–900.

    PubMed  Google Scholar 

  15. Wiffen PJ, McQuay HJ, Edwards JE, Moore RA: Gabapentin for acute and chronic pain. Cochrane Database Syst Rev 2005, 20:CD005452.

  16. Sator-Katzenschlager SM, Scharbert G, Kress HG, et al.: Chronic pelvic pain treated with gabapentin and amitriptyline: a randomized controlled pilot study. Wien Klin Wochenschr 2005, 117:761–768.

    Article  CAS  PubMed  Google Scholar 

  17. Roman H, Puscasiu L: Guidelines for the management of painful endometriosis. Chirurgia 2008, 103:265–274.

    CAS  PubMed  Google Scholar 

  18. Kroner-Herwig B: Chronic pain syndromes and their treatment by psychological interventions. Curr Opin Psychiatry 2009, 22:200–204.

    Article  PubMed  Google Scholar 

  19. •• Eccleston C, Palermo TM, Williams AC, et al.: Psychological therapies for the management of chronic and recurrent pain in children and adolescents. Cochrane Database Syst Rev 2009, 15:CD003968. This literature review explores evidence supporting the role of psychological therapies as intervention for chronic pain.

    Google Scholar 

  20. Haugstad GK, Haugstad TS, Kirste UM, et al.: Continuing improvement of chronic pelvic pain in women after short-term Mensendieck somatocognitive therapy: results of a 1-year follow up study. Am J Obstet Gynecol 2008, 199:615.e1–e8.

    Google Scholar 

  21. Turk DC, Swanson KS, Tunks ER: Psychological approaches in the treatment of chronic pain patients: when pills, scalpels, and needles are not enough. Can J Psychiatry 2008, 53:213–223.

    PubMed  Google Scholar 

  22. Molton IR, Graham C, Stoelb BL, Jensen MP: Current psychological approaches to the management of chronic pain. Curr Opin Anaesthesiol 2007, 20:485–489.

    Article  PubMed  Google Scholar 

  23. Butler AC, Chapman JE, Forman EM, Beck AT: The empirical status of cognitive behavioral therapy: a review of meta-analyses. Clin Psychol Rev 2006, 26:17–31.

    Article  PubMed  Google Scholar 

  24. Candido K, Stevens RA: Intrathecal neurolytic blocks for the relief of cancer pain. Best Pract Res Clin Anaesthesiol 2003, 17:407–428.

    Article  PubMed  Google Scholar 

  25. Soysal ME, Soysal S, Gurses E, Ozer S: Laparoscopic presacral neurolysis for endometriosis-related pelvic pain. Hum Reprod 2003, 18:588–592.

    Article  PubMed  Google Scholar 

  26. Chen FP, Lo TS, Soong YK: Management of chylous ascites following laparoscopic presacral neurectomy. Hum Reprod 1998, 13:880–883.

    Article  CAS  PubMed  Google Scholar 

  27. Kwok A, Lam A, Ford R: Laparoscopic presacral neurectomy: a review. Obstet Gynecol Surv 2001, 56:99–104.

    Article  CAS  PubMed  Google Scholar 

  28. Plancarte R, Amescua C, Patt RB, Aldrete JA: Superior hypogastric plexus block for pelvic cancer pain. Anesthesiology 1990, 73:236–239.

    CAS  PubMed  Google Scholar 

  29. Wechsler RJ, Maurer PM, Halpern EJ, Frank ED: Superior hypogastric plexus block for chronic pelvic pain in the presence of endometriosis: CT techniques and results. Radiology 1995, 196:103–106.

    CAS  PubMed  Google Scholar 

  30. Michalek P, Dutka J: Computed tomography-guided anterior approach to the superior hypogastric plexus for noncancer pelvic pain: a report of two cases. Clin J Pain 2005, 21:553–556.

    Article  PubMed  Google Scholar 

  31. Cariati M, De Martini G, Pretolesi F, Roy MT: CT-guided superior hypogastric plexus block. J Comput Assist Tomogr 2002, 26:428–431.

    Article  PubMed  Google Scholar 

  32. Plancarte R, de Leon-Casasola OA, El-Helaly M, et al.: Neurolytic superior hypogastric plexus block for chronic pelvic pain associated with cancer. Reg Anesth 1997, 22:562–568.

    CAS  PubMed  Google Scholar 

  33. de Oliveira R, dos Reis MP, Prado WA: The effects of early or late neurolytic sympathetic plexus block on the management of abdominal or pelvic cancer pain. Pain 2004, 110:400–408.

    Article  PubMed  Google Scholar 

  34. Plancarte R, Amescua C, Patt RB: Presacral blockade of the ganglion of Walther (ganglion impar). Anesthesiology 1990, 73:A751.

    Google Scholar 

  35. Reig E, Abejón D, del Pozo C, et al.: Thermocoagulation of the ganglion impar or ganglion of Walther: description of a modified approach. Preliminary results in chronic, nononcological pain. Pain Pract 2005, 5:103–110.

    Article  PubMed  Google Scholar 

  36. Swofford JB, Ratzman DM: A transarticular approach to blockade of the ganglion impar (ganglion of Walther). Reg Anesth Pain Med 1998, 23:103.

    Article  Google Scholar 

  37. •• Practice Committee of American Society for Reproductive Medicine: Treatment of pelvic pain associated with endometriosis. Fertil Steril 2008, 90(Suppl 5):S260–S269. This article outlines current recommendations for treatment strategy for endometriosis.

    Google Scholar 

  38. Farquhar C: Endometriosis. BMJ 2007, 334:249–253.

    Article  PubMed  Google Scholar 

  39. Ferrero S, Camerini G, Ragni N, et al.: Norethisterone acetate in the treatment of colorectal endometriosis: a pilot study. Hum Repro 2009 Oct 10 (Epub ahead of print).

  40. •• Vercellini P: Endometriosis: current therapies and new pharmacological developments. Drugs 2009, 69:649–675. This article includes detailed descriptions of medical management options, including mechanisms of action.

    Article  CAS  PubMed  Google Scholar 

  41. Fedele L, Somigliana E, Frontino G, et al.: New drugs in development for the treatment of endometriosis. Expert Opin Investig Drug 2008, 17:1187–1202.

    Article  CAS  Google Scholar 

  42. Yap C, Furness S, Farquhar C: Pre and post operative medical therapy for endometriosis surgery. Cochrane Database Syst Rev 2004, 3:CD003678.

    PubMed  Google Scholar 

  43. Flower A, Liu JP, Chen S: Chinese herbal medicine for endometriosis. Cochrane Database Syst Rev 2009, 3:CD006568.

    PubMed  Google Scholar 

  44. Wayne PM, Kerr CE, Schnyer RN, et al.: Japanese-style acupuncture for endometriosis-related pelvic pain in adolescents and young women: results of a randomized sham-controlled trial. J Pediatr Adolesc Gynecol 2008, 21:247–257.

    Article  PubMed  Google Scholar 

  45. Jacobson TZ, Duffy JM, Barlow D: Laparoscopic surgery for pelvic pain associated with endometriosis. Cochrane Database Syst Rev 2009, 4:CD001300.

    PubMed  Google Scholar 

  46. Catenacci M, Sastry S, Falcone T: Laparoscopic surgery for endometriosis. Clin Obstet Gynecol 2009, 52:351–361.

    Article  PubMed  Google Scholar 

  47. Hart R, Hickey M, Maouris P, Buckett W: Excisional surgery versus ablative surgery for ovarian endometriomata. Cochrane Database Syst Rev 2008, 2:CD004992.

    PubMed  Google Scholar 

  48. Shakiba K, Bena JF, McGill KM, et al.: Surgical treatment of endometriosis: a 7-year follow up on the requirement for further surgery. Obstet Gynecol 2008, 111:1285–1292.

    PubMed  Google Scholar 

  49. Mattoras R, Elorriaga MA, Pijoan JI, et al.: Recurrence of endometriosis in women with bilateral adnexectomy (with or without total hysterectomy) who received hormone therapy. Fertil Steril 2002, 77:303–308.

    Article  Google Scholar 

  50. •• Stepniewska A, Pomini P, Guerriero M, et al.: Colorectal endometriosis: benefits of long-term follow-up in patients who underwent laparoscopic surgery. Fertil Steril 2009 Oct 15 (Epub ahead of print). This is a well-organized overview of theories of pain, medical, and surgical interventions.

  51. National Kidney and Urology Diseases Information Clearinghouse: Interstitial cystitis/painful bladder syndrome: how is IC/PBS diagnosed? Available at http://kidney.niddk.nih.gov/Kudiseases/pubs/interstitialcystitis/#diagnosis. Accessed December 2009.

  52. Hanno P, Nordling J, van Ophoven A: What is new in bladder pain syndrome/interstitial cystitis? Curr Opin Urol 2008, 18:353–358.

    Article  PubMed  Google Scholar 

  53. Hanno PM: Interstitial cystitis epidemiology, diagnostic criteria, clinical markers. Rev Urol 2002, 4(Suppl 1):S3–S8.

    PubMed  Google Scholar 

  54. van de Merwe JP, Nordling J, Bouchelouche P, et al.: Diagnostic criteria, classification, and nomenclature for painful bladder syndrome/interstitial cystitis: an ESSIC proposal. Eur Urol 2008, 53:60–67.

    Article  PubMed  Google Scholar 

  55. •• Moutzouris DA, Falagas ME: Interstitial cystitis: an unsolved enigma. Clin J Am Soc Neph 2009, 4:1844–1857. This article provides a concise yet comprehensive review of recent literature surrounding diagnosis and management of IC. Included is a discussion surrounding the evolving definition of IC along with recent statistics on prevalence. Theories on pathophysiology, clinical presentation, diagnostic strategies, and treatment options are also addressed.

    Article  Google Scholar 

  56. •• Shorter B, Lesser M, Moldwin RM, Kushner L: Effect of comestibles on symptoms of interstitial cystitis. J Urol 2007, 178:145–152. The results from a validated questionnaire used to assess the impact of various foods, beverages, and medications on symptoms related to IC are presented in this article. Several items are implicated in the exacerbation of IC.

    Article  PubMed  Google Scholar 

  57. •• Dimitrakov J, Kroenke K, Steers WD, et al.: Pharmacologic management of painful bladder syndrome/interstitial cystitis. Arch Intern Med 2007, 167:1922–1929. This is a review of 21 randomized controlled trials evaluating the efficacy of various oral and intravesicular medications in the treatment of IC. The authors concluded that only PPS demonstrated sufficient beneficial effect in the management of IC, and that data on other agents are insufficient for further recommendation.

    Article  CAS  PubMed  Google Scholar 

  58. van Ophoven A, Heinecke A, Hertle L: Safety and efficacy of concurrent application of oral pentosan polysulfate and subcutaneous low-dose heparin for patients with interstitial cystitis. Urology 2005, 66:707–711.

    Article  PubMed  Google Scholar 

  59. Sant GR, Propert KJ, Hanno PM, et al.: A pilot clinical trial of oral pentosan polysulfate and oral hydroxyzine in patients with interstitial cystitis. J Urol 2003, 170:810–815.

    Article  CAS  PubMed  Google Scholar 

  60. van Ophoven A, Hertle L: Long-term results of amitriptyline treatment for interstitial cystitis. J Urol 2005, 174:1837–1840.

    Article  PubMed  Google Scholar 

  61. Marinkovic SP, Moldwin R, Gillen LM, Stanton SL: The management of painful bladder syndrome in women. BMJ 2009, 239:337–342.

    Google Scholar 

  62. Sairanen J, Forsell T, Ruutu M: Long-term outcome of patients with interstitial cystitis treated with low dose cyclosporine A. J Urol 2004, 171:2138–2141.

    Article  CAS  PubMed  Google Scholar 

  63. Soucy F, Gregoire M: Efficacy of prednisone for severe refractory ulcerative interstitial cystitis. J Urol 2005, 173:841–843.

    Article  CAS  PubMed  Google Scholar 

  64. •• Dawson TE, Jamison J: Intravesical treatments for painful bladder syndrome/interstitial cystitis. Cochrane Database Syst Rev 2007, 4:CD006113. This Cochrane review complied analysis of recent publications evaluating the efficacy of intravesical therapies for treatment of IC. Although data on the majority of treatments yielded mixed results, both BCG and oxybutynin were highlighted as potentially promising agents for the future.

    PubMed  Google Scholar 

  65. Cervigni M, Natale F, Natasa L, et al.: A combined intravesical therapy with hyaluronic acid and chondroitin for refractory painful bladder syndrome/interstitial cystitis. Int Urogynecol J 2008, 19:943–947.

    Article  CAS  Google Scholar 

  66. Daha L, Lazar D, Simak R, Heinz P: The effects of intravesical pentosan polysulfate treatment on the symptoms of patients with bladder pain syndrome/interstitial cystitis: preliminary results. Int Urogynecol J 2008, 19:987–990.

    Article  Google Scholar 

  67. Chuang YC, Lee WC, Lee WC, Chiang PH: Intravesical liposome versus oral pentosan polysulfate for interstitial cystitis/painful bladder syndrome. J Urol 2009, 182:1393–1400.

    Article  CAS  PubMed  Google Scholar 

  68. Toft BR, Nordling J: Recent developments of intravesical therapy of painful bladder syndrome/interstitial cystitis: a review. Curr Opin Urol 2006, 16:268–272.

    Article  PubMed  Google Scholar 

  69. Giannantoni A, Porena M, Costantini E, et al.: Botulinum A toxin intravesical injection in patients with painful bladder syndrome: 1-year follow-up. J Urol 2008, 179:1031–1034.

    Article  CAS  PubMed  Google Scholar 

  70. Otten DP, Teichman JM: What is the value of cystoscopy with hydrodistention for interstitial cystitis? Urology 2005, 66:494–499.

    Article  Google Scholar 

  71. Hsieh CH, Hsieh CJ, Chang HC: Treatment of interstitial cystitis with hydrodistention and bladder training. Int Urogynecol J 2008, 19:1379–1384.

    Article  Google Scholar 

  72. Oeslemans D, van Kerrebroeck P: Sacral nerve stimulation for neuromodulation of the lower urinary tract. Neurol Urodyn 2008, 27:28–33.

    Article  Google Scholar 

  73. Whitemore KE, Payne CK, Diokno AC, Lukban JC: Sacral neuromodulation in patients with interstitial cystitis: a multicenter clinical trial. Int Urogynecol J 2003, 14:305–309.

    Article  Google Scholar 

  74. Siegel S, Paszkiewicz E, Kirkpatrick C, et al.: Sacral nerve stimulation in patients with chronic intractable pelvic pain. J Urol 2001, 166:1742–1745.

    Article  CAS  PubMed  Google Scholar 

  75. Everaert K, Devulder J, De Muynk M, et al.: The pain cycle: implication for the diagnosis and treatment of pelvic pain syndromes. Int Urogynecol J Pelvic Floor Dysfunct 2001, 12:9–14.

    Article  CAS  PubMed  Google Scholar 

  76. Kapural L, Narouze SN, Janicki TI, Mekhail N: Spinal cord stimulation is an effective treatment for the chronic intractable visceral pelvic pain. Pain Med 2006, 7:440–443.

    Article  PubMed  Google Scholar 

  77. Comiter CV: Sacral neuromodulation for the symptomatic treatment of refractory interstitial cystitis: a prospective study. J Urol 2003, 169:1369–1373.

    Article  PubMed  Google Scholar 

  78. Peters KM, Killinger KA, Boguslawski BM, Boura JA: Chronic pudendal neuromodulation: expanding available treatment options for refractory urologic symptoms. Neurol Urodyn 2009 Sept 28 (Epub ahead of print).

  79. Rössberger J, Fall M, Jonsson O, Peeker R: Long-term results of reconstructive surgery in patients with bladder pain syndrome/interstitial cystitis: subtyping is imperative. Urology 2007, 70:638–642.

    Article  PubMed  Google Scholar 

  80. Stones RW, Mountfield J: Interventions for treating chronic pelvic pain in women. Cochrane Database Syst Rev 2005, 2:CD000387.

  81. Keltz M, Gera PS, Olive DL: Prospective randomized trial of right-sided paracolic adhesiolysis for chronic pelvic pain. JSLS 2006, 10:443–446.

    PubMed  Google Scholar 

  82. •• Roman H, Hulsey TF, Marpeau L, Hulsey TC: Why laparoscopic adhesiolysis should not be the victim of a single randomized clinical trial. Am J Obstet Gynecol 2009, 200:136.e1–e4. This thought-provoking editorial investigates the current literature and challenges regarding evidence for or against adhesiolysis.

    Article  Google Scholar 

  83. Rabinovici J, Stewart EA: New interventional techniques for adenomyosis. Best Pract Res Clin Obstet Gynaecol 2006, 20:617–635.

    Article  PubMed  Google Scholar 

  84. Farquhar C, Brosens I: Medical and surgical management of adenomyosis. Best Pract Res Clin Obstet Gynaecol 2006, 20:603–616.

    Article  PubMed  Google Scholar 

  85. Levgur M: Diagnosis of adenomyosis: a review. J Reprod Med 2007, 52:177–193.

    PubMed  Google Scholar 

  86. Yoon SW, Kim KA, Cha SH, et al.: Successful use of magnetic resonance-guided focused ultrasound surgery to relieve symptoms in a patient with symptomatic focal adenomyosis. Fertil Steril 2008, 90:2018.e13–e15.

    Article  Google Scholar 

  87. Fukunishi H, Funaki K, Sawada K, et al.: Early results of magnetic resonance-guided focused ultrasound surgery of adenomyosis: analysis of 20 cases. J Minim Invasive Gynecol 2008, 15:571–579.

    Article  PubMed  Google Scholar 

  88. Chen CL, Li FJ, Liu P, et al.: The relevance between the effect on dysmenorrheal and the time of surgery of artery embolization in the treatment of adenomyosis [in Chinese]. Zhonghua Fu Chan Ke Za Zhi 2008, 43:884–887.

    PubMed  Google Scholar 

  89. Chen Cl, Liu P, Zeng BL, et al.: Intermediate and long term clinical effects of uterine arterial embolization in treatment of adenomyosis [in Chinese]. Zhongua Fu Chan Ke Za Zhi 2006, 41:660–663.

    Google Scholar 

  90. Ganeshan A, Upponi S, Hon LQ, et al.: Chronic pelvic pain due to pelvic congestion syndrome: the role of diagnostic and interventional radiology. Cardiovasc Intervent Radiol 2007, 30:1105–1111.

    Article  PubMed  Google Scholar 

  91. Nicholson T, Basile A: Pelvic congestion syndrome: who should we treat and how? Tech Vasc Interv Radiol 2006, 9:19–23.

    Article  PubMed  Google Scholar 

  92. Liddle AD, Davies AH: Pelvic congestion syndrome: chronic pelvic pain caused by ovarian and internal iliac varices. Phlebology 2007, 22:100–104.

    Article  CAS  PubMed  Google Scholar 

  93. Soysal ME, Soysal S, Vicdan K, Ozer S: A randomized controlled trial of goserelin and medroxyprogesterone acetate in the treatment of pelvic congestion. Hum Reprod 2001, 16:931–939.

    Article  CAS  PubMed  Google Scholar 

  94. Farquhar CM, Rogers V, Franks S, et al.: A randomized controlled trial of medroxyprogesterone acetate and psychotherapy for the treatment of pelvic congestion. Br J Obstet Gynaecol 1989, 96:1153–1162.

    CAS  PubMed  Google Scholar 

  95. Shokeir T, Amr M, Abdelshaheed M: The efficacy of Implanon for the treatment of chronic pelvic pain associated with pelvic congestion: 1-year randomized controlled study. Arch Gynecol Obstet 2009, 280:437–443.

    Article  PubMed  Google Scholar 

  96. Creton HD, Hennequin L, Kohler F, Allaert FA: Embolisation of symptomatic pelvic veins in women presenting with non-saphenous varicose veins of pelvic origin: three year follow-up. Eur J Vasc Endovasc Surg 2007, 34:112–117.

    Article  CAS  PubMed  Google Scholar 

  97. Kim HS, Malhotra AD, Rowe PC, et al.: Embolotherapy for pelvic congestion syndrome: long term results. J Vasc Interv Radiol 2006, 17:289–297.

    Article  PubMed  Google Scholar 

Download references

Disclosure

No potential conflicts of interest relevant to this article were reported.

Author information

Authors and Affiliations

  1. Gynecologic Specialities, Department of Gynecology and Obstetrics, Johns Hopkins University, 600 North Wolfe Street, Phipps 249, Baltimore, MD, 21287, USA

    Isabel C. Green

  2. Department of Gynecology and Obstetrics, Johns Hopkins University, 600 North Wolfe Street, Phipps 279, Baltimore, MD, 21287, USA

    Sarah L. Cohen

  3. Department of Obstetrics and Gynecology, Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, Room 121, Baltimore, MD, 21224, USA

    Dayna Finkenzeller

  4. Division of Pain Medicine, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 550 North Broadway, Suite 301, Baltimore, MD, 21205, USA

    Paul J. Christo

Authors
  1. Isabel C. Green
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sarah L. Cohen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dayna Finkenzeller
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Paul J. Christo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Paul J. Christo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Green, I.C., Cohen, S.L., Finkenzeller, D. et al. Interventional Therapies for Controlling Pelvic Pain: What is the Evidence?. Curr Pain Headache Rep 14, 22–32 (2010). https://doi.org/10.1007/s11916-009-0089-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11916-009-0089-7

Keywords

Search

Navigation