-- ============================================================================ =======TITLE: PELVIC PAIN
RESOURCE PERSON: PROF NG SOON CHYE
1) DEFINITION
Pain experienced by the female in the pelvis
2) CAUSES
May be gynaecological or non-gynaecological Gynaecological causes result in primary or secondary dysmenorrhoea Non-gynaecological include intestinal, sacral or low lumbar and urinary causes idiopathies
3) CLINICAL APPROACH
3.1 History - PID, IUCD, ectopic, endometriosis 3.2 Physical examination - general, abdominal, pelvic 3.3 Investigation FBC AND ESR CA125 if endometriosis is suspected Gynaecological ultrasound Laparoscopy and hysteroscopy
3.4 Treatment Primary dysmenorrhoea:
ovulatory-use oral contraceptive pills or anti- prostaglandins
Chronic PID: adhesiolysis especially at laparoscopy wide-spectrum antibiotics KIV rotational in extreme cases, THBSO and pelvic clearance
Endometriosis:
(a) surgical (b) medical eg. progestogens
danazol
decapeptyl