Chronic Pelvic Pain

Pain on the pelvic area longer than 6 months, can be cause by bones or urinary tract and unrelated to reproductive organs.

You need a comprehensive exam with work up for gastrointestinal system and / or urogynecologist.

The following are diagnostic tests / imaging for diagnosis of chronic pelvic pain:

ULTRASOUND

A test in which sound waves are used to examine internal structures.  A pelvic ultrasound examination is accurate in detecting pelvic masses, including ovarian cysts (sometimes caused by ovarian endometriosis) and uterine fibroids. However, ultrasound is not helpful in the diagnosis of irritable bowel syndrome, diverticulitis, or painful bladder syndrome.

LAPAROSOCOPY

A surgical procedure called a laparoscopy may be helpful in diagnosing some causes of chronic pelvic pain such as endometriosis and chronic pelvic inflammatory disease. Laparoscopy is a procedure that is often done as a day surgery. Most women are given general anesthesia to induce sleep and prevent pain. A thin telescope with a camera is inserted through a small incision just below the navel. Through the telescope, the surgeon can see the contents of the abdomen, especially the reproductive organs. If the laparoscopy is normal, the physician can then focus the diagnostic and treatment efforts on non-gynecologic causes of pelvic pain.

COLONOSCOPY

An exam of the entire colon using a small, lighted instrument. Colonoscopy can be used as a screening test (recommended beginning at age 50 years and continuing until 75 years) or as a follow-up diagnostic tool when the individual has symptoms.

SIGMOIDOSCOPY

A test in which a slender device is placed into the rectum and lower colon to look at the interior walls of the rectum and part of the colon; should be done every five years with FOBT (Fecal Occult Blood Test) every three years.

 CYSTOSCOPY

A test in which the inside of the urethra and bladder are examined. Cystoscopy may be the investigation of choice when a patient has chronic pelvic pain with predominantly bladder symptoms. Interstitial cystitis, now often referred to as painful bladder syndrome / bladder pain syndrome, is a common cause of chronic pelvic pain.

Treatment includes symptomatic pain control, physical therapy + biofeedback, nutritional + lifestyle changes in addition to surgical approach.

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