[Gynecologic pain syndrome as psychovegetative and reflex-mediated disorders and imbalances]

Chronic lower abdominal pain without organic findings represent a costly diagnostic and therapeutic problem. They are presumably caused by decentralized neurovegetative disturbances. Their treatment is a connection between somatotherapy and psychotherapy. The manifestations of these disorders are local sympathical hypertonia (with algodystrophical vasoconstrictions) or local parasympathical hypertonia and amphotonical disturbances with pathological vasodilatations, respectively, as well as accompanying disturbances of the local lymphatic system. Moreover, non-gynecological causes such as the musculus psoas syndrome are often not recognized. Diagnosis of the patient's neurovegetative status is an essential prerequisite of treatment. First, a relaxation by analgesia should take place, and then whole-body neurovegetative stimulations for centralization of the nervous control and, additionally, distant reflex and decongestive measures should be performed. For physiotherapeutical purposes, the inner genital is reached best via the vagina. In order to change the neural tonus of the Frankenhäuser ganglions the Vagimoran therapy is the optimal choice. The cutivisceral stimulations are applied via the segments S2-S4 and Th10-Th12 (suprapubical!). In future, chronotherapy in the framework of the imitation strategy and the consideration of therapeutical surroundings are essential elements of therapy.