To the Editor: We read the recent article by Pitts and colleagues1 with interest, given the rising trend of diagnosed chronic pelvic pain (CPP) in Australian women. The article identified three types of CPP, but did not differentiate pain into the two major categories of nociceptive (visceral and somatic) and neuropathic. In pain management settings it is considered essential, where possible, to make this differentiation, as it significantly alters management strategies, particularly in relation to medication. While the true incidence of neuropathic pain is unknown, it is believed to be underdiagnosed and inadequately treated. A 2008 French study based on a nationwide postal survey revealed a 6.9% prevalence of neuropathic pain in the general population, with 5.1% of respondents reporting pain levels as moderate to severe.2
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- Metro Spinal Clinic, Melbourne, VIC.
- 1. Pitts MK, Ferris JA, Smith AMA, et al. Prevalence and correlates of three types of pelvic pain in a nationally representative sample of Australian women. Med J Aust 2008; 189: 138-143. <MJA full text>
- 2. Bouhassira D, Lantéri-Minet M, Attal N, et al. Prevalence of chronic pain with neuropathic characteristics in the general population. Pain 2008; 136: 380-387.
- 3. Perry CP. Peripheral neuropathies causing chronic pelvic pain. J Am Assoc Gynecol Laparosc 2000; 7: 281-287.
- 4. Siegel S, Paszkiewicz E, Kirkpatrick C, et al. Sacral nerve stimulation in patients with chronic intractable pelvic pain. J Urol 2001; 166: 1742-1745.
- 5. Kim SW, Paick JS, Ku JH. Percutaneous posterior tibial nerve stimulation in patients with chronic pelvic pain: a preliminary study. Urol Int 2007; 78: 58-62.
- 6. Bouhassira D. [Definition and classification of neuropathic pain] [French]. Presse Med 2008; 37: 311-314.