Pelvic pain syndromes and their management in advanced gynaecological malignancy
Pelvic pain syndromes and their management in advanced gynaecological malignancy
Gynaecological malignancies constitute approximately 20 per cent of visceral cancers in women. Cancer in the pelvis causes progressive pelvic and perineal pain and complications such as uteretic obstruction with uremia, and lymphatic and venous obstruction. It also causes bowel or bladder outlet obstruction when the tumour invades the rectum or the bladder. Adding to these complications are significant anatomical and functional damages caused by invasive oncological treatments. One of the serious problems caused by neurotoxic chemotherapy, vulvectomy, vaginectomy, hysterectomy, pelvic exenteration, and other treatments is pain. This chapter covers the pathophysiology and pharmacological treatment of pelvic pain in gynaecological malignancies. The basic principles of care are not treated here; rather the focus is on the anatomy of the pelvis and the pathophysiological mechanisms of pain in order to understand pain and pain management. The chapter also includes some general methods of managing pain through the use of oral medications and interventional procedures.
Keywords: gynaecological malignancies, visceral cancers, pelvis, progressive pelvic pain, perineal pain, pain, pathophysiology of pain, pharmacological treatment, pelvic pain, pelvic anatomy
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