Pain in lower abdomen, due to problems in the pelvis or, reproductive system (uterus, tubes and ovaries) which persists for more than six months.
Pelvic Pain may be on and off, dull or sharp, mild, moderate or severe. It may spread through the lower back, to the buttocks or thighs. This pain may arise while passing stools or having sex. Chronic pelvic pain may be constant or intermittent pain that has been present for six months or more.
It could be due to the following conditions,
- Endometriosis
- Pelvic Infection
- Ovarian Cyst
- Cancer
- Fibroids
- Ectopic Pregnancy
- Adenomyosis
The Ultrasound is a fantastic and cost-effective tool to identify pain. A CT or MRI can also give additional diagnostic insights.
Management is based on the cause of the Pain.
- Endometriois – Depending on the stage of endometriosis, conservative or surgical treatment is offered.
- Pelvic Infection – Antibiotic course is given for a week or two weeks.
- Ovarian Cyst – Removal of cyst laparoscopically. If the cyst is functional, conservative treatment can be offered upto 5cms.
- Fibroids – Generally fibroids are painless. If it causes pain, it means it is undergoing degeneration or necrosis and it has to be removed laparoscopically.
- Adenomyosis – Adenomyosis generally produces lots of pain unlike fibroid. If it is localised, laparoscopic removal of the adenomyosis is done. If it is global, then medical management is offered along with excision.
- Ectopic Pregnancy – When pregnancy forms in the tube, at first it produces severe pain and secondly in early stages, it can be manged with medicines. If it ruptures it has to be removed laparoscopically.
