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Pelvic Pain

Pelvic Pain

Pelvic pain is a complex condition as it is commonly caused by multiple factors simultaneously. Pain can be acute from an infection like PID (pelvic inflammatory disease), vaginal infection, bladder infections, colitis (inflammation of the bowel), ovarian cysts (like a hemorrhagic ruptured cyst or ovarian torsion), cyclical when it is related to the menstrual cycle (see the section of menstrual disorders), or chronic pain which is sometimes linked to anxiety, depression, and history of abuse.

Here is a list divided by organs and systems

  • Vagina: high tone pelvic floor dysfunction, recurrent vaginitis, cancer, vaginal cysts, trauma

  • Cervical: cervicitis ( inflammation of the cervix ) from viruses, STDs

  • Uterus: fibroid and adenomyosis 

  • Ovarian: many types of cysts including endometrioma, dermoid,  benign, and cancerous tumors

  • Endometriosis: not only cause pelvic pain but also infertility. Unfortunately, endometriosis is often diagnosed late after many years of suffering and patient tend not to get treated appropriately even after they get diagnosed. (Hence, it is very important to excise all of the endometriosis during surgery without leaving any residual.)

  • Bladder: Interstitial cystitis or Bladder Pain Syndrome, recurrent UTI, stones

  • Bowel: chronic diverticulitis, Irritable bowel syndrome, Inflammatory bowel disease

  • Miscellaneous: pelvic abscess, pelvic adhesions

Treatment options

  • Multimodal approach is the most effective by addressing the patient as a whole, not just the medical condition. As mentioned, when pain lasts a long time (months) it does affect the psychology and should be addressed through counseling.  The treatments for the variety of conditions above are too many to include here. They range from medications to office procedure and surgery. If surgery is offered it should have a balance of being the most effective in improving the pain while being the least invasive to shorten the recovery.

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