ABSTRACT

Introduction

According to the Integral System, chronic pelvic pain (CPP) in the female co-occurs with abnormal bladder emptying, urge and nocturia symptoms with a common causation, lax uterosacral ligaments (USLs).

Methods

In our systematic review, the PubMed database was used for the literature search using the keywords algorithm which included “chronic pelvic pain” and “uterosacral ligaments”. Relevant studies regarding CPP origin, USLs involvement in causation and symptom cure after surgical or non-surgical treatment were analysed in this review.

Results

We found evidence that when USLs become lax, the gravity forces act on the uterus and vagina, develop congestion. In this respect, posterior compartment repair could be used in order to reinforce the USLs.

Conclusions

CPP and other symptoms related to posterior zone of the pelvic floor were mainly due to USL laxity and repairing these ligaments restored its clinical manifestations, as predicted by the Integral Theory.