About UGAP Pain Care:
POPSS (Pain Over Pubis and Surrounding Structures) syndrome is not an uncommon condition. It is an enthesopathy (tendonitis) and/or periosteitis, somewhat similar to periosteitis pubis. This paper will provide background and describe lessons learned in 35 years of clinical experience treating this condition.
Abstract
To swiftly diagnose and treat patients with POPSS Syndrome (Pain Over Pubis & Surrounding Structures) also described as Undiagnosed Groin, Lower Abdominal and Pelvic (U-GAP) Pain.
Patients and Methods
Retrospective study of total of 203 patients seen between 1983 and 2006: 49 males (24%) and 154 females (76%). Precipitating factors were previous lower abdominal surgeries in 46%, infections in 7.3%, sports activities in 3.9% and non-specific in 33.4% of patients.
Results
Out of 203 patients 139 (68%) had excellent results, 43 (21%) had satisfactory and 9 (4%) and partial to poor response. Six were lost to follow-up.
Conclusion
Awareness is key in suspecting this condition. A detailed history and thorough physical examination of the abdomen, vagina and rectum and utilizing 7 signs described help further in pinpointing the diagnosis. Emphasis is placed on conservative multimodatility treatment. Steroid injections help in pain management besides helping in confirming the diagnosis. Emotional management and physical therapy play a significant role in treatment and preventing recurrences.