Chronic Pelvic Pain


2.1. Methods

Additional information can be found in the general Methodology section online at the EAU website: A list of associations endorsing the EAU Guidelines can also be viewed online at the above address.

Recommendations within the Guidelines are developed by the panels to prioritise clinically important care decisions. The strength of each recommendation is determined by the balance between desirable and undesirable consequences of alternative management strategies, the quality of the evidence (including certainty of estimates), and the nature and variability of patient values and preferences. This decision process, which can be reviewed in the strength rating forms which accompany each guideline statement, addresses a number of key elements:

  1. the overall quality of the evidence which exists for the recommendation [18];
  2. the magnitude of the effect (individual or combined effects);
  3. the certainty of the results (precision, consistency, heterogeneity and other statistical or study related factors);
  4. 4the balance between desirable and undesirable outcomes;
  5. the impact and certainty of patient values and preferences on the intervention.

Strong recommendations typically indicate a high degree of evidence quality and / or a favourable balance of benefit to harm and patient preference. Weak recommendations typically indicate availability of lower quality evidence, and/or equivocal balance between benefit and harm, and uncertainty or variability of patient preference [19].

The 2012 full text update was based on a systematic review (SR) of literature using the Embase and Medline databases, the Cochrane Central Register of controlled trials and the PsycINFO and Bandolier databases to identify the best evidence from randomised controlled trials (RCTs) (Level of Evidence 1 [LE: 1]) according to the rating schedule adapted from the Oxford Centre for Evidence-based Medicine Levels of Evidence. Where no LE: 1 literature could be identified the search was moved down to the next lower level on the rating scale.

Extensive use of free text ensured the sensitivity of the searches, resulting in a substantial body of literature to scan. Searches covered the period January 1995 to July 2011 and were restricted to English language publications. In 2017, a scoping search for the previous five years was performed and the guideline was updated accordingly.

In 2021, a new section was included on Post-Surgical Pain Syndrome. In addition, the classifications in the Guideline have been amended to reflect ICD-11 released by WHO. The latest version of ICD-11 will be available for member states to report with from January 2022. For the 2024 print, a scoping search for the previous three years was performed and the guideline was updated accordingly.

2.2. Review

This document was subject to peer review prior to publication in 2021.