Program

Course Learning Objectives:

1. Perform a thorough evaluation of a patient with genitopelvic pain.
2. Evaluate different forms of genitopelvic pain based upon presentation.
3. Develop a diagnosis and treatment plan for multiple presentations of genitopelvic pain.

Friday, August 12, 2022 from 3:00 – 5:00 pm EST

THE TOOLS

Moderator: Jill M. Krapf, MD, MEd, IF

Session Learning Objectives:

1. Outline the tools needed to evaluate genitopelvic pain
2. Utilize the tools in an approach to a patient with genitopelvic pain

Preliminary Program:

3:00 – 3:05 pm: Welcome and Introduction
3:05 – 3:15 pm: Nosology and Epidemiology
3:15 – 3:25 pm: History
3:25 – 3:40 pm: Physical Exam/Basic Anatomy
3:40 – 4:00 pm: Biopsychosocial Approach to Diagnosis and Treatment
4:00 – 4:15 pm: The Role of the Head – Fear Avoidance, Pain-related Anxiety
4:15 – 4:45 pm: Practice Cases – How to Interview and Approach a Real Patient
4:45 – 5:00 pm: Questions

Friday, September 9, 2022 from 3:00 – 5:00 pm EST

THE VESTIBULE – “It hurts to insert”

Moderator: Sarah Cigna, MD, MS, IF

Session Learning Objectives:

1. Locate distinct anatomy of the female genitals and pelvis related to genitopelvic pain.
2. Differentiate associated factors in provoked vestibulodynia.

Preliminary Program:

3:00 – 3:05 pm: Welcome and Introduction
3:05 – 3:20 pm: Anatomy of Vestibule, Levator Ani Muscles, Pudendal Nerve Branches to Vestibule
3:20 – 3:35 pm: Role of Hormones and Inflammation in Vestibular Health
3:35 – 3:45 pm: Pelvic Floor Dysfunction Alone
3:45 – 3:55 pm: Hormonally-associated/GSM/Lactation/Cancer Treatments
3:55 – 4:05 pm: Congenital Neuroproliferative Vestibulodynia
4:05 – 4:15 pm: Acquired Neuroproliferative Vestibulodynia
4:15 – 4:20 pm: Postpartum Laceration Healing
4:20 – 5:00 pm: Questions – “Ask the Experts”

Friday, October 21, 2022 from 3:00 – 5:00 pm EST

THE CLITORIS – “It hurts to touch”

Moderator: Rachel S. Rubin, MD, IF

Session Learning Objectives:

1. Discuss structural and nerve-related causes of clitoral pain.
2. Categorize structural versus nerve-related causes of clitoral pain based upon presentation.

Preliminary Program:

3:00 – 3:05 pm: Welcome and Introduction
3:05 – 3:20 pm: Detailed Anatomy of the Clitoris
3:20 – 4:15 pm: Diagnostic Algorithm for:

1. Structural
   1. Clitoral Adhesions/Keratin Pearls/Abscesses
   2. Tumors (Neuroma, Cancer)
   3. History of Labiaplasty
2. Nerve Related
   1. Pudendal Neuralgia
   2. PGAD
3. Priapism of Clitoris

4:15 – 5:00 pm: Questions – “Ask the Experts”

Friday, November 11, 2022 from 3:00 – 5:00 pm EST

THE BLADDER/URETHRA – “It hurts to pee”

Moderator: Rachel S. Rubin, MD, IF

Session Learning Objectives:

1. Interpret the components that contribute to bladder and urethral pain
2. Evaluate a patient with chronic bladder and/or urethral pain

Preliminary Program:

3:00 – 3:05 pm: Welcome and Introduction
3:05 – 3:20 pm: Anatomy of Bladder, Ureter, Urethra, Innervation, Important Pelvic Floor Muscles
3:20 – 3:30 pm: Normal Urine Character on UA and Role of Hormones
3:30 – 4:15 pm: Diagnostic Algorithm for: Pelvic Floor Dysfunction

1. Infection
   1. Recurrent UTI
   2. Ureaplasma/Mycoplasma – When to Treat?
2. Nephrolithiasis
3. Painful Bladder Syndrome (“Interstitial Cystitis”)
4. Cancer

4:15 – 5:00 pm: Questions – ”Ask the Experts”

Friday, January 13, 2023 from 3:00 – 5:00 pm EST

THE VULVA – “It hurts to sit and wear pants”

Moderator: Jill M. Krapf, MD, MEd, IF

Learning Objectives:

1. Recognize causes of generalized vulvar pain and dermatoses
2. Map out neurologic and inflammatory causes of generalized vulvar pain

Preliminary Program:

3:00 – 3:05 pm: Welcome and Introduction
3:05 – 3:20 pm: Anatomy
3:20 – 4:15 pm: Diagnostic Algorithm for Generalized Vulvodynia

1. Nerve-related
   1. Pudendal Neuralgia
   2. PGAD – Arousal is Sometimes Described as “Discomfort”
2. Dermatologic
   1. Inflammatory
      1. Contact Dermatitis
      2. Lichen Simplex Chronicus
      3. Lichen Sclerosus
      4. Lichen Planus
      5. MCAS/Systemic Inflammation
   2. Infectious
      1. Cutaneous Yeast
      2. Shingles
      3. Post-herpetic Neuralgia from HSV1/2
   3. Cancer/VIN
3. Pelvic Floor Muscle Dysfunction

4:15 – 5:00 pm: Questions – “Ask the Experts”

Friday, February 10, 2023 from 3:00 – 5:00 pm EST

THE PELVIS – “It hurts deep inside”

Moderator: Sarah Cigna, MD, MS, IF

Session Learning Objectives:

1. Identify the anatomy of the pelvic floor
2. Distinguish between different conditions that can cause pelvic pain

Preliminary Program:

3:00 – 3:05 pm: Welcome and Introduction
3:05 – 3:20 pm: Anatomy of Pelvic Bone Structure, Path of Important Sacral Nerves, Deeper Muscle Groups, and Relative Positions of Pelvic Organs
3:20 – 4:15 pm: Diagnostic Algorithm for:

1. Endometriosis
2. Pelvic Adhesions
   1. History of Appy, Endo, PID/STI, Surgery
3. Less Appreciated Internal Muscles like Psoas
4. Painful Orgasms
5. Pelvic Organ Prolapse
6. Active PID
7. Post-LEEP/Hysterectomy Changes

4:15 – 5:00 pm: Questions – “Ask the Experts”