Chronischer Unterbauchschmerz der Frau

Zusammenfassung Hintergrund Der chronische Unterbauchschmerz der Frau stellt in der gynäkologischen Praxis ein schwieriges diagnostisches und therapeutisches Problem dar, das im Umgang mit den betroffenen Frauen eine stete Herausforderung ist. Gynäkologische Ursachen Mögliche gynäkologische Ursachen und Befunde sind Endometriose, Adhäsionen bzw. die „pelvic inflammatory disease“ (PID), pelvine Varikosis und das „ovarian retention syndrome/ovarian remnant syndrome“. Andere somatische Ursachen sind das Reizdarmsyndrom, das „bladder pain syndrome“ bzw. die interstitielle Zystitis sowie Erkrankungen des muskuloskeletalen Systems und des Bindegewebes. Psychosoziale Ursachen Gesicherte psychosoziale Ursachen sind eine hohe Komorbidität mit psychologischen Faktoren wie Angststörungen, Substanzabhängigkeit oder depressiven Störungen, wobei eine eindeutige Zuordnung zu sozialen Faktoren nicht nachgewiesen ist. Auch ein Zusammenhang mit körperlichem und sexuellem Missbrauch kann nicht abschließend bewertet werden. Diagnostik und Therapie In der Diagnostik sind die Anamnese, gynäkologische Untersuchung und Durchführung einer Laparoskopie als wichtige Schritte zu nennen. Multidisziplinäre Therapieansätze sind als Erfolg versprechend anzusehen. Die psychosomatische Grundversorgung soll von Beginn an in das Behandlungskonzept integriert werden. Auch eine Psychotherapie ist frühzeitig einzuleiten. Abstract Background Chronic pelvic pain in women represents a difficult diagnostic and therapeutic problem in the gynecological practice which is always a challenge when dealing with affected women. Gynecological causes Possible gynecological causes are endometriosis, adhesions and/or pelvic inflammatory disease (PID), pelvic varicosis and ovarian retention syndrome/ovarian remnant syndrome. Other somatic causes are irritable bowel syndrome, bladder pain syndrome, interstitial cystitis and fibromyalgia. Psychosocial factors Psychosocial causes contributing to chronic pelvic pain are a high comorbidity with psychological factors, such as anxiety disorders and substance abuse or depression but the influence of social factors is less certain. The association with physical and sexual abuse also remains unclear. Diagnostics and therapy Important diagnostic steps are recording the patient history, a gynecological examination and laparoscopy. Multidisciplinary therapeutic approaches are considered to be very promising. Basic psychosomatic care and psychotherapy should be integrated into the therapeutic concept at an early stage. Similar content being viewed by others Literatur ACOG Committee on Practice Bulletins—Gynecology (2004) ACOG Practice Bulletin No. 51. Chronic pelvic pain. Obstet Gynecol 103:589–605 Albert H (1999) Psychosomatic group treatment helps women with chronic pelvic pain. J Psychosom Obstet Gynaecol 20:216–225 AWMF (Hrsg) (2009) Chronischer Unterbauchschmerz der Frau. 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Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Siedentopf, F., Sillem, M. Chronischer Unterbauchschmerz der Frau. Schmerz 28, 300–304 (2014). https://doi.org/10.1007/s00482-014-1408-4 Published: Issue date: DOI: https://doi.org/10.1007/s00482-014-1408-4