Neurologic disease presenting as chronic pelvic pain

Neurologic disease as a cause of chronic pelvic pain may be more common tha n previously reported. We report three cases wherein patients with complain ts of pelvic pain were subsequently found to have neurologic disease involv ing the lumbosacral spine. In all three cases, the presenting features were complaints of cyclic or noncyclic lower abdominal pain attributed to endom etriosis, pelvic inflammatory disease, or uterine fibroids. When convention al therapies failed to resolve the pain, magnetic resonance imaging (MRI) o f the lumbosacral spine showed a neoplasm in one patient and disk herniatio n in two patients. Evolving lumbar disk disease or intradural neoplasms in the upper lumbar area can produce symptoms interpreted as pelvic pain. Symp toms consistent with radiculopathy occurred late in the course of each of t he three cases reported.