Pelvic Floor and Urodynamic Interventions
Aria Health Center for Gynecology & Women's Health
Most women experience pelvic pain of some type at some point in their lives, and a very long list of conditions can cause such pain. Many of these conditions, though, can cause severe or longer-term pelvic pain, including uterine fibroids; endometriosis; cancer; menstrual conditions; ovarian cysts; gastrointestinal conditions; ectopic pregnancy; and urologic conditions, such as interstitial cystitis – to name just some.
Two other general terms refer to conditions that can also cause pelvic pain:
• Pelvic inflammatory disease. In this infectious condition, bacteria or other infectious organisms have crossed the cervical barrier and irritated and affected the uterus, fallopian tubes, or adjacent pelvic structures. The result can be persistent inflammation or long-term scarring. Pelvic inflammatory disease can also encompass symptoms from sexually transmitted diseases, vaginal infections, or urinary infections.
• Adhesions. Abnormal physical connections between the surface of organs and structures in the pelvis, usually caused by connective tissue such as scar tissue, can form after injury to tissue in the area due to surgery, infection, or chronic conditions such as endometriosis. These connections can cause pulling, pressure, or stiffness that results in pelvic pain.
Pelvic pain may be acute (sharp and with rapid onset), intermittent, or constant. Every woman's tolerance for pelvic pain is different, but certainly when such pain begins to interfere with activities, to affect other aspects of physical health, or to cause distress, it should be evaluated.
With so many potential causes of pelvic pain, isolating the basis of a woman's discomfort may take time and patience. The staff at Aria's Center for Gynecology & Women's Health may use a variety of different steps to determine the cause of pelvic pain. These include:
• taking a medical history;
• physical examination (both standing and prone);
• and a number of different lab and imaging studies.
Ultrasound conducted externally on the pelvis or with a probe introduced through the vagina may be useful. In addition, our specialists may perform a diagnostic hysteroscopy to view the interior of the uterus or laparoscopy to view the interior of the pelvis. CT and MR imaging, as well as other radiologic, urologic, and gastroenterologic tests may also be employed.
Aria's women's center can offer treatment or refer for treatment for conditions underlying pelvic pain, including psychological factors that may exacerbate the experience of pelvic pain. Treatment can include medications (including analgesics, anti-inflammatories, hormone therapy, muscle relaxants, or antidepressants), heat therapy, nerve blocks, physical therapy (relaxation techniques), minimally invasive surgery using hysteroscopy or laparoscopy, or major surgery (such as hysterectomy).