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Chronic pelvic pain


Chronic pelvic pain is a broad term that defines long-lasting sufferance (more than 6 months), non-menstrual related and without an apparent cause. It is essentially a diagnosis of exclusion and all other organic dysfunctions must be eliminated prior to reaching this terminology. A significant number of conditions may express through pain and each can benefit from targeted care, therefore it is utmost important to keep an open-minded approach when examining each variable. Furthermore the visceral pain differs from the skin or muscle pain in the sense that the location of pain doesn’t necessarily coincide with the real active process causing it (“referred pain”). So it depends on your doctor capability to make a thorough judgment before concluding.

Assuming all other causes have been exhausted systematically and one suffers from chronic pelvic pain that is functional rather than organic in nature, there are still hopes for addressing this issue even when traditional analgesic medication fails. We discussed in another chapter about the conduction of the pain stimulus from pelvis to your brain. In this instance the transmission is abnormal, depending on nervous irritation rather than a true illness.


There are two procedures available today to interrupt this pathway for midline pelvic pain: LUNA (laparoscopic uterosacral nerve ablation) and presacral neurectomy. The results are variable and depend mostly on the technique used. The drawback of LUNA is loss of uterine support with predisposition for prolapse. If childbearing is completed, we recommend hysterectomy with pelvic support restoration to further address this risk. Please feel free and contact our physician for any clarification related with these procedures that have a very limited availability among gynecology providers but are available through minimally invasive, same day surgery here.

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