Chronic pelvic pain is a condition wherein the pelvic region has been under pain for more than 6 months. It affects mostly women, with a 1:7 ratio. Chronic pelvic pain has numerous causes, from intestinal to gynecological to urological, and therefore requires multidisciplinary treatment.
Most patients with chronic pelvic pain book appointments to multiple doctors, but 1/3 of them will not get proper diagnosis and treatment. This leads to psychological distress and eventually a bad quality of life.
Pelvis Floor Causes and Treatment
- Pelvic Inflammatory Disease (PID) – an infection in the female’s upper reproductive system (uterus, fallopian tubes, ovaries). It is usually caused by Chlamydia trachomatis and Neisseria gonorrhea. Symptoms include fever, lower abdominal pain, new or different discharge, cervical motion tenderness, uterine tenderness, adnexal tenderness, painful intercourse, or irregular menstruation. If not treated, PID may lead to endometritis, salpingitis, tubo-ovarian abscess, and pelvic peritonitis. Scar tissue formation due to PID episodes may lead to tubal blockage, increasing the risk of infertility and long-term pelvic and abdominal pain. Early identification of PID is important to eliminate the effects of infection.
- Pelvic Endometriosis – a condition of the growth of the endometrium outside the uterus. This uterine lining behaves like the one inside the uterus, undergoing recurrent changes like monthly bleeding, except that it happens in the abdomen or other organs. This causes inflammatory reaction, appearance of scar tissue or cysts filled with blood. Endometriosis may also cause heavy menstrual flow, painful intercourse, and infertility. It can be treated by procedures that lessen or eliminate the pain and other symptoms.
- Interstitial Cystitis – also known as painful bladder syndrome wherein patients have the urge to urinate more often and with smaller amount of urine than usual. This causes bladder and pelvic soreness, and frequent and painful urination.
- Puborectalis Syndrome And Pudendal Chronic Neuralgia – these are diagnosed by examining the levator ani and other trigger points. Nerve conduction studies are then done, if necessary. Treatments include biofeedback, pelvic floor rehabilitation, and in rare cases, direct infiltration with local anesthesia and corticosteroids on the nerve.
- Diverticular Disease – a condition wherein small inflamed bulges develop in the large intestine’s lining. Symptoms include lower abdominal pain and bloating; in more serious cases severe pain in the left abdomen, high fever (above 38C or 100.4F), and bloody diarrhea. Many people may instead have diverticulosis, as they may not experience any symptoms. Diagnosis is via colonoscopy and treatment consists of a special diet and cycles of probiotics and antibiotics.
It is important to carefully have a correct diagnosis to be able to treat the problem.