Summary of Surgical Treatment for Chronic Pelvic Pain...

From: Helen Dynda (olddad66@runestone.net)
Sun May 27 18:04:39 2001


|||> Summary of Surgical Treatment for Chronic Pelvic Pain

[]> The source of chronic pelvic pain may be:

1.) reproductive organ,

2.) urological,

3.) musculoskeletal - neurological,

4.) gastrointestinal, or

5.) myofascial.

A psychological component almost always is a factor whether as an antecedent event or presenting as depression as result of the pain.

[]> Surgical interventions for chronic pelvic pain include:

1) resection or vaporization of vulvar/vestibular tissue for HPV induced or chronic vulvodynia/vestibulitis;

2) cervical dilation for cervix stenosis;

3) hysteroscopic resection for intracavitary or submucous myomas or intracavitary polyps;

4) myomectomy or myolysis for symptomatic intramural, subserosal or pedunculated myomas;

5) adhesiolysis for peritubular and periovarian adhesions, and enterolysis for bowel adhesions, adhesiolysis for all thick adhesions in areas of pain as well as thin adhesions affecting critical structures such as ovaries and tubes;

6) salpingectomy or neosalpingostomy for symptomatic hydrosalpinx;

7) ovarian treatment for symptomatic ovarian pain;

8) uterosacral nerve vaporization for dysmenorrhea;

9) presacral neurectomy for disabling central pain primarily of uterine but also of bladder origin;

10) resection of endometriosis from all surfaces including removal from bladder and bowel as well as from the rectovaginal septal space. Complete resection of all disease in a debulking operation is essential; 11) appendectomy for symptoms of chronic appendicitis, and chronic right lower quadrant pain;

12) uterine suspension for symptoms of collision dyspareunia, pelvic congestion, severe dysmenorrhea, cul-de-sac endometriosis;

13) repair of all hernia defects whether inguinal, femoral, spigelian, ventral or incisional;

14) hysterectomy if relief has not been achieved by organ preserving surgery such as resection of all endometriosis and presacral neurectomy, or the central pain continues to be disabling. Before such a radical step is taken, MRI of the uterus to confirm presence of adenomyosis may be helpful;

15) trigger point injection therapy for myofascial pain and dysfunction in pelvic and abdominal muscles.

To read more about these surgical treatments, go to the following website:

http://www.pelvicpain.org/html/surgical_treatment.html


Enter keywords:
Returns per screen: Require all keywords: