Chronic pubic pain is usually more common in women in their 20s and 30s. Symptoms include a burning sensation, itching, inflammation and swelling, as well as tingling in the pubic area, sometimes even around the rectum. People who suffer from chronic pubic pain usually feel pain during intercourse, but sometimes it can strike when completely unexpected. According to the National Association for the Study of Chronic Pubic Pain, these patients typically see more than seven doctors before they finally realize what the problem is before they are properly seen. But because so little research has been done on chronic pubic pain, many physicians don’t know how to detect the condition, and even less about how to treat it. Thankfully, more research is being done on this condition, which provides a wealth of information for diagnosis. The following common causes and treatment are summarized: I. Chronic Pelvic Pain Syndrome 1. Psychological chronic pelvic pain: a dull ache, persistent attacks, often after awakening pain, encountering psychosocial factors when the onset of pain, pain site and nerve distribution inconsistent, no radiating pain, metastatic changes and diffuse, years and years to maintain the same pain, the examination will not trigger or increase the pain, dealing with interpersonal relationships when it is not appropriate It will happen when dealing with interpersonal relationships. Organic pelvic pain: the pain is sharp, spasmodic, intermittent, can occur at any time, sleep can be awakened by pain, along the nerve distribution pathway radiation, typical pressure points, development or quickly get better or more intense, in the manipulation of the examination after the production or exacerbation, is not affected by emotions. Etiology: (1) Gastrointestinal system constipation, irritable bowel syndrome, enteritis, intestinal diverticulitis. (2) Urinary system urethritis, cystitis. (3) Nervous, muscular, skeletal system pelvic floor tension myalgia, pyriformis syndrome, abdominal hernia, rectus abdominis tendon sprain, myofasciitis. (4) Reproductive system inflammation of the reproductive organs, pelvic cysts, uterine fibroids, malformations of the reproductive tract, history of previous pelvic surgery, endometriosis, uterine adenomyosis, pelvic stasis syndrome, cervical canal obstruction, and residual ovarian syndrome. Treatment requires the use of multidisciplinary integrated approach, including surgery, drugs (gabapentin), physiotherapy, psychotherapy, dietary therapy, etc., the goal of treatment is to relieve pain, improve function and eliminate psychological barriers, but the long duration of the disease is not effective in the treatment of the second, perineal descent syndrome is a pelvic floor disorders due to a variety of reasons for the pelvic floor muscle degeneration, dysfunction, the patient in the quiet state of the perineum in a low position. The perineum position is lower when the patient is in a quiet state, or the degree of perineal descent exceeds the normal range when the patient is straining to defecate, which is clinically manifested as exit constipation or fecal incontinence. It is often seen as a concomitant lesion of rectal intussusception and rectal prolapse. In recent years, with the wide application of fecal imaging, there are more and more reports of descending perineum syndrome, which is a concomitant lesion of rectal intussusception or rectal prolapse. The main symptoms are the feeling of incomplete stool, anal swelling, difficulty in defecation, increased frequency of stool, perineal pain, partial incontinence, some patients have a history of applying various laxatives, a few have mucus blood stools, defecation or walking after the anus has a mass prolapse, and so on. Third, chronic prostatitis is also known as the pelvic floor muscle pain syndrome, the symptomatic manifestation of diverse, and the symptoms and inflammation is not proportional to the severity of some patients in the prostate fluid contains a large number of pus cells but asymptomatic, and some patients with a normal or near-normal prostate fluid examination, but the performance of the clinical symptoms is very heavy. Common symptoms can be summarized in the following five categories: 1, urinary discomfort can appear urinary frequency urethral burning, pain can be radiated to the head of the penis; early morning urethral orifice mucus mucus and pus secretion, cloudy urine or urine flow after stool; in severe cases, there can be terminal hematuria and urinary difficulty or urinary retention. 2, local symptoms of the posterior urethra perineum and anus discomfort pressure or fullness, squatting or bowel movement is more. 3, radiating pain prostate or seminal vesicles have rich sympathetic innervation, inflammation occurs when the internal tension of the gland increases, can stimulate the sympathetic nerves caused by metastatic low back pain, the pain can be radiated to the penis testicles scrotum inguinal perineum abdominal thighs buttocks rectum and other places. 4, sexual dysfunction chronic prostatitis can cause loss of libido or disappearance of ejaculation pain hematospermia premature ejaculation impotence spermatorrhea as well as infertility. The use of drugs and warm water sitz bath and other methods of treatment. Fourth, pubic nerve compression, also known as pubic canal syndrome, is a rare cause of chronic pain, the pubic nerve located in the pelvis is intercepted or compressed. The pain is noticeable and worsens when sitting. Other symptoms include genital numbness, erectile dysfunction, fecal incontinence and urinary incontinence. Typical pain is caused by sitting, relieved by standing, and disappears when lying down or sitting on a sitting stool. If the perineal pain is related to the position of the body, it suggests plumbing syndrome, which is the most valuable diagnostic basis. In addition there is the problem of incontinence. It needs to be differentiated from the more common chronic prostatitis/chronic pelvic pain syndrome or interstitial cystitis. Causes Pregnancy or accident or incidental surgical accident. Anatomical abnormalities can cause PNE because the pubic nerve fuses into other anatomical structures or becomes trapped between the iliac node and the iliopsoas ligament.Vigorous and prolonged bicycle riding, especially with a poorly shaped or improperly positioned bicycle seat, can ultimately thicken the iliac node and the iliopsoas ligament, which can put the pubic nerve between the two and lead to PNE.TreatmentsTreatment options include behavior modification, Physical therapy, pain relievers, pubic nerve closure, surgical nerve release and the latest high frequency pulse therapy. V. Pelvic cancer pain: patients with pelvic malignant tumors often suffer from intractable abdominal pain in the late stage, which seriously affects the quality of life of patients. Uterine cervix cancer: it is common with invasive cancer, with peak incidence at 60-64 years old, invading pelvis in late stage and compressing peripheral nerves, causing sciatica or persistent pain in sacroiliac area on one side and lumbago. Endometrial cancer: accounting for 20-30% of female malignant tumors, mostly seen in elderly women, menopausal women account for 70-75% of the total number of cases. In the late stage, it infiltrates the peripheral tissues and compresses the peripheral nerves, causing pain in lower abdomen and lumbar-sacral area, which can radiate to the lower limbs and feet. Ovarian malignant tumor: abdominal pain, lumbar pain or lower limb pain occurs in late stage. For some patients who are not relieved after standardized medication, or whose medication cannot be continued due to severe side effects, disfiguring inferior epigastric plexus block can relieve pelvic cancer pain.