Authors: Lamvu G, Villegas-Echeverri J, Allaire C, As-Sanie S, Carrillo J, Khalil S, Horne A, Wang A, Munro M. Int J Gynecol Obstet. 2025;00:1-16. 

DOI:  10.1002/ijgo.70522

Summary by: Morgan Briggs MD, Mayo Clinic, Rochester

Summary:

Chronic pelvic pain (CPP) remains an often-overlooked healthcare condition due to significant challenges in the diagnosis and treatment of CPP in addition to systemic barriers such as inadequate clinician training, resources, and time. To address this gap, the International Federation of Gynaecology and Obstetrics (FIGO) and the International Pelvic Pain Society (IPPS) developed a consensus statement evaluating the challenges to CPP care and presenting a framework to navigate these challenges. To address the first step of this framework, the authors developed the FIGO-IPPS “R U MOVVING SOMe” classification system that standardizes the evaluation and management of CPP in females. Using a modified RAND/UCLA Delphi methodology, the authors engaged a diverse international panel of stakeholders that included clinicians, researchers, relevant medical societies, lay people, pelvic pain experts, educators, patients, and journal editors. Through three iterative rounds of surveys and discussions, consensus was achieved on the definition of CPP and a classification system.

The final consensus for the definition of CPP was “pain localized to the pelvis that may be cyclical or non-cyclical and typically lasts 3 months or longer after failed initial therapies.” The final classification system was composed of 12 system categories: Reproductive, Urinary, Musculoskeletal, Other (not otherwise classified), Vulvovaginal, Vascular, Idiopathic, Neurologic, Gastrointestinal, Sensitization/Nociplastic, Overlapping Pain Conditions, and Mental Health (Figure 3). The R U MOVVING categories include conditions associated with specific organ systems while the SOMe conditions modify pain in the presence of co-existing organ system pathology, typically. In addition, the system allows for overlapping and co-existing conditions, enhancing its clinical utility.

The authors suggest that the “R U MOVVING SOMe” system has the potential to improve clinician-patient communication, validate patient experiences, and enhance both clinical care and research efforts. Ongoing work aims to further integrate this classification system into routine clinical practice.

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