Pelvic Pain

Chronic pelvic pain is defined as pain in the lower abdomen that has been going on for at least 6 months It may or may not be associated with menstrual periods.

Gynecological Causes of Pelvic Pain

  • Endometriosis and endometrioma
  • Adenomyosis
  • Adhesions (intra-abdominal scar tissues)
  • Pelvic inflammatory disease
  • Myomas (fibroids)
  • Pelvic congestion
  • Uterus position disorders
  • Ovarian cysts
  • Uterine prolapse
  • Ligament tears after difficult childbirth

Other Causes of Pelvic Pain

  • Irritable bowel syndrome
  • Chronic appendicitis
  • Inflammatory bowel diseases
  • Diverticulitis
  • Fibromyalgia
  • Fistula
  • Abnormal bladder function
  • Chronic urethritis
  • Cystitis
  • Psychological problems
  • Nerve compression
  • Diagnosis of Chronic Pelvic Pain
  • To find the underlying cause, careful medical history and several tests ranging from physical examination to laparoscopy are carried out and the diagnosis is made.

Treatment

Using only pain relievers is not the solution. Using painkillers without addressing  the cause of chronic pelvic pain will make the diagnosis difficult. Treatment based on underlying cause of the disease is the best option.

If your doctor can identify the condition that causes chronic pelvic pain, cause-based treatment is given. However, if the cause cannot be found, the treatment is applied for the relief of pain. It is not always possible to treat pain completely. The success of the treatment involves improving the quality of life by minimizing pain.

Some methods used in treatment:

Pain relievers: They can partially relieve pain, but alone is not enough to solve the problem.

Antibiotics: It is recommended if the cause of pain is infection.

Hormone therapy: In managing pain associated with the menstrual cycle, birth control pills or other hormonal drugs may work. Dienogest, a type of progesterone specific to endometriosis, is also used often. Injections that induce temporary menopause for a month or three months can be used in treatment.

Antidepressants: Some antidepressants may help with chronic pain. Antidepressants have been shown to work even in women who are not depressed.

Local anesthetic: It can be used with or without steroids in diagnosis and treatment.

Botox: In special cases (Painful Pelvic Floor Muscle Spasm), it can be performed by physicians trained on this subject. Especially, the pudendal nerve, which makes sensory innervation of the muscles and pelvic region, can be blocked. It can also be used for abdominal wall pain. It is often necessary to repeat this treatment.

Surgery: If there is endometriosis, adhesions may be opened with Laparoscopic or Robotic surgery and endometriosis foci can be removed. It benefits from surgery in cases such as nerve involvement and vascular entrapment, which are special causes of pain. In some rare complicated cases, removal of the uterus (hysterectomy) and ovaries may be recommended in women who have completed their reproductive life.

As a result, it is a complex process to evaluate women with pelvic pain in detail and to provide treatment alternatives for the cause.


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