Chronic Pelvic Pain

Pain in your lower torso just between your hips could be chronic pelvic pain. It comes and goes, is sometimes dull, sometimes sharp, but it doesn’t go away unless treated.

Chronic pelvic pain is a persistent pain below the belly button and between the hips. It becomes a medical condition if the pain lasts for at least six months.

When the cause of chronic pelvic pain cannot be identified, the goal of treatment is customarily to reduce the pain and improve the quality of life.

• Severe and steady pain
• Dull aching
• Cramping or sharp pains
• Pain that comes and goes
• Heaviness or pressure deep within your pelvis
• Pain while urinating or having a bowel movement
• Pain during intercourse
• Pain when sitting or standing for long periods

Chronic pelvic pain can be a symptom of another disease or just a condition on its own. Causes may include:

• Endometriosis
• Musculoskeletal problems
• Ovarian remnant
• Fibroids
• Chronic pelvic inflammatory disease
• Irritable bowel syndrome
• Pelvic congestion syndrome
• Painful bladder syndrome (interstitial cystitis)
• Psychological factors, such as depression, chronic stress, or a history of sexual or physical abuse

Many pelvic disorders can cause pelvic pain. Your urologist or urogynecologist will conduct a detailed review of your pain and personal health history. Your doctor may also ask you to keep a journal of your pain and other symptoms.

Tests or exams commonly ordered to diagnose the condition will include a pelvic exam to evaluate the pelvic area, ultrasound to detect cysts or masses in the uterus, fallopian tubes or ovaries, and laparoscopy to detect chronic pelvic inflammatory disease or endometriosis.

Your urogynecologist or urologist may also order the following: blood work to check cell counts, a urinalysis, lab tests to check for infections like gonorrhea or Chlamydia, and imaging tests such as abdominal X-rays, magnetic resonance imaging (MRI), or computerized tomography (CT) to help detect abnormal growths or structures.

The goal of treating chronic pelvic pain is to reduce symptoms, improve overall function, and boost quality of life. Since the cause and consequence of the pain may involve multiple mechanisms, urogynecologists apply a holistic treatment approach that addresses the physical, behavioral, psychological, and sexual components.

At Advanced Urology Institute, we are proud to have advanced diagnostic technology and the expertise to pinpoint the cause of your chronic pelvic pain. Once we identify the underlying cause, we ensure the treatment will address it. In cases where the cause is not clearly defined, the treatment typically manages the pain and other symptoms.

Depending on the cause, your provider may recommend pain-relieving medications, hormone treatment, antibiotics, or antidepressants. Your provider may also recommend physical therapy, neuro-stimulation, trigger point injections, or psychotherapy.

When there is a need to correct an underlying problem responsible for the pain, a surgical procedure, such as laparoscopic surgery or hysterectomy, may be recommended. In many cases, however, the optimal treatment approach involves a combination of treatments.