Perinneal pain and dysfunction in urological practice

The approach to the pathogenesis, diagnosis and treatment of diseases of the pelvic organs has changed, becoming more complex. It is connected with the phenomenon of so-called cross-sensitization, and the fact that in the pathogenesis of chronic pelvic pain syndrome is dominated by myofascial (spastic) symptoms of pelvic floor and pudendal nerve neuropathy. This leads to a change in terminology, which creates a certain amount of confusion. In this paper we attempt to consider in detail the symptoms of the female pelvic organs, which are important in daily practice of urologist. Among pain syndromes scientists identify painful bladder syndrome, mainly caused by cross-sensitization; pudendal nerve neuropathy, which might be caused by pudendal nerve compression in the channel of Alcock, piriformis-syndrome, pudendal nerve damage during childbirth, trauma, and pelvic malignancies; myofascial syndromes mainly caused by chronic spasm of the muscles - the pelvic ligaments. Storage and evacuation dysfunctions of the bladder are divided into overactive bladder with detrusor overactivity; overactive bladder with increased bladder filling sensation, the so-called “OAB without OAB”, and stress urinary incontinence Among the sexual dysfunction a provocative vulvodynia can be noted. The paper includes a clinical case that illustrates the aforementioned dysfunctions