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From my standpoint, pelvic pain falls into three classifications:
I. Pain from normal functioning of the reproductive organs - will probably resolve without treatment, may be severe, but is self-limited. A frequent cause of this is a "functional" ovarian cyst. It is easy for a doctor to fall into the trap of doing surgery for such problems because the patient wants the problem solved, and feels that surgery will offer a quick "fix."
II. Pelvic pain that may need treatment, but not on an urgent basis - Examples of this would include pain from endometriosis, scar tissue or a growing fibroid tumor. Chronic pelvic pain also falls into this category. Schedule an office appointment for the evaluation of this type of pain.
III. Pelvic pain that needs urgent surgery or hospitalization - Examples of this type of pelvic pain would be a ruptured tubal pregnancy, appendicitis, severe pelvic infection or torsion (twisting) of an ovary. Generally this type of pain will require you go to the Emergency Room.
MY APPROACH INVOLVES:
Ask the right questions
Listen to you carefully
Get records from the Emergency Room
Get records from other doctors
Get results of any testing
Perform physical examination
Perform pelvic ultrasound examination
Understand how badly the pain is disrupting your life
Know your childbearing desires
Know other treatments you've tried
Using knowledge and experience...
I will try my very best to help you.
I may only treat with reassurance
Antibiotics are sometimes appropriate
Birth control pills sometimes work best
Mirena IUD is a new approach to pain relief
Other hormonal suppression therapies are considered
Diagnostic or therapeutic laparoscopy is sometimes wise
Referral to other specialists (Gastro or Urologist)
Referral to a Chronic Pain specialist
Consider Minimally Invaisive Hysterectomy