Verified

Under Review

7/29/21, 4:10 PM

Dalton LaBarge

A 39F G1P1001 presents for a new patient visit and evaluation of chronic pelvic pain. Diffuse pain has worsened over 14 months. She recently moved to the area after a divorce. She completely avoids romantic relationships due to severe dyspareunia. She has regular periods and no history of STIs. No urinary or GI symptoms. Previous ultrasounds and diagnostic laparoscopies showed no abnormalities. Which of the following initial approaches will most likely benefit this patient?

Provide resources for easy physical therapy exercises

C0-create longitudinal plan to evaluate organic causes

Suggest neuromodulator trial for pain control

Refer to psychiatry for evaluation of mood-disorder

Correct Answer:

B

(b) Effective management of chronic pelvic pain depends on establishing a therapeutic, longitudinal relationship that affirms our patients pain is real. Co-creating a focused and minimally invasive plan to investigate organic causes is an important aspect of shared decision making and trust building.

(a)(c) While neuromodulators or PT are effective pain management strategies, starting our assessment by discussing interventions would be premature at this point

(d) CBT and psychiatry are important team members in chronic pain management however initially creating too wide of a referral network can hinder therapeutic relationship building

“Chronic Pelvic Pain: ACOG Practice Bulletin, Number 218.” Obstetrics and gynecology (New York. 1953) 135.3 (2020): e98–e109. Web.