Session 8: Towards patient-centered medicine

  • Experiences with shared decision-making in patients with endometriosis 
  • The quality of care delivered to patients from the patient perspective
  • A patient experience 
  • Roundtable discussion with representatives of patient associations

 Session 7:  Chronic pelvic pain at different stages of life.

  • Sexuality and pelvic pain through the life span 
  • Vestibulodynia versus vaginismus 
  • Vulvodynia in the elderly woman: Genitourinary syndrome of the menopause, and dermatological disorders. Diagnostic approach and therapeutic proposals 
  • Erectile dysfunction, orgasm and pain 
  • Pregnancy and childbirth in patients with chronic pelvic pain 

Discussion

Session 2: Endometriosis and Pain

  • Mechanisms of pain in Endometriosis 
  • Medical treatment for endometriosis pain: an update 
  • Non-pharmacological and non-surgical therapies for endometriosis pain 
  • Predictors of treatment failure in patients with endometriosis-associated chronic pelvic pain 
  • Recurrence of pain after surgery, what to do?

Discussion

Session 1: Transition from acute to chronic pain. Central sensitization.

  • Visceral chronic pain in the absence of injury: how to change paradigms 
  • When pain uncouple from harm: what do we understand for central sensitization? 
  • How can we diagnose central sensitization? 
  • When to operate and when not to operate? 
  • How how to manage a patient with central sensitisation for surgery/peri-operatively  

Discussion

Workshop 2: Multidisciplinary management, from theory to practice

Clinical cases: Management of pelvic and perineal pain.
Discussion of 3 clinical scenarios by a panel of experts, to represent a multidisciplinary team of a chronic pelvic pain clinic. (3 blinded clinical cases), emulating a clinical committee on chronic pelvic pain. 
Theory is great, but how do you do it in practice?

Workshop 1: Infiltration and nerve block techniques

  • Trans-gluteal truncal and radicular diagnostic infiltrations
  • Infiltration of local anaesthetics / botulinum toxin in the levator ani, piriformis and internal obturator muscles 
  • Blockade of the coccyx, the sacroiliac joint and the ganglion impar 

Discussion

Session 6 : Pelvic pain, chronicity and mental health

  • Anhedonia and chronic pain 
  • Trauma-informed  strategies and practices for physiotherapy: Working with complex trauma, sexual assault survivors in physiotherapy 
  • What does it mean to be anally retentive? Characteristics of anal personality and chronic pain 
  • Revelation and/or evocation of traumatic events during an interview: What to do and for what purpose? 

Discussion

Session 5: Pelvic pain in the primary care setting.

  • How to improve ambulatory management of chronic pelvic pain? 
  • What are the basics of the clinical examination and complementary tests? 
  • The role of the general practitioner and the emergency physician in dealing with chronic pelvic pain 
  • The role of the physiotherapy in initial care 

Discussion

Session 4: Coccygodynia, search for a consensus 

  • Diagnosis and pathophysiological mechanisms 
  • Association of coccydynia and pudendal neuralgia. 
  • Manual therapy for the treatment of coccygodynia 
  • Medical and surgical management of coccygodynia. 

Discussion

Session 3: Neuroscience of movement in pelvic pain

  • Biomechanics of the pelvis 
  • Therapeutic exercise in chronic pain 
  • Involvement of walking in chronic pelvic pain. Relationship between goat and chronic pelvic pain.
  • Pyramidal syndrome in chronic pelvic pain. 
  • Lumbar pathology and chronic pelvic pain 

Discussion