Management of Gynaecological Chronic Pelvic Pain in the Emergency Setting- A Scoping Review

Gynaecological chronic pelvic pain (CPP) has a high prevalence among adult women. This pain can be debilitating and life-impacting, affecting quality of life across all dimensions of health. Many barriers to specialised care exist, leading women to rely on unscheduled general care like emergency departments or in the out-of-hospital.

The review aimed to investigate evidence regarding pain management for women presenting to acute, non-specialist settings for gynaecological CPP. Secondary aims were to identify areas of suboptimal care and potential for improvement of patient outcomes.

A scoping review was conducted using the Joanna Briggs Institute scoping review framework with the PRISMA extension. Academic and grey literature were searched.

Initially, 1563 records were identified, with 50 from grey literature and 801 from citation screening. Nineteen were included for descriptive analysis. Key themes were pharmacological agents, holistic care and ongoing care. Appraisal of the literature showed varying quality.

This scoping review highlights the need to define clinicians' roles in managing gynaecological CPP exacerbations in acute, non-specialist settings. It identifies gaps in best-practice pain assessment, management and clinician education, with guidelines and recommendations often of poor quality. Effective CPP management requires a multidisciplinary and biopsychosocial approach and, despite limitations, clinicians can enhance knowledge and practice scope to improve patient outcomes.