Pelvic Pain

Pelvic pain may be acute or chronic and usually indicates a problem with tissues in the pelvic area which can range from the gynaecological organs to the bowel or urinary tract.  One of the most common causes of pelvic pain is endometriosis but other causes include adhesions, pelvic infection, fibroids, ovarian cysts and polyps. 

History and examination

To determine the cause of pelvic pain it is very important to take a careful history and perform an examination.  Specific types of pain or findings on examination can usually suggest the cause fairly accurately.  For example, endometriosis can cause specific symptoms such as pain at the time of the period, deep pain with intercourse, aching after intercourse, pain or looseness of the bowels at the time of the period or even urinary frequency at the time of the period.  With endometriosis, examination may show tenderness, thickening, tethering and nodule or cyst development in the pelvis. Careful pelvic examination can also indicate adhesions, fibroids and ovarian cysts. 

Investigations

Various investigations may be needed to further delineate the causes of pelvic pain.  A pap smear is usually taken and if there is a history of infection, vaginal swabs will be taken.  Blood tests may be necessary, particularly if there is a significant ovarian cyst.  Ultrasound can be very useful and should be performed by an experienced gynaecological ultrasonographer.  Ulltrasound, however, usually cannot diagnosis endometriosis or adhesions unless the disease is significant.  Ultimately, the most accurate investigation is ‘looking’ with endoscopic (key hole) surgery - laparoscopy, hysteroscopy, cystoscopy.  Treatment can then be performed at the same time.

Treatments and procedures

Laparoscopic Surgery

Laparoscopic surgery is often called “keyhole” surgery. This is because it is performed through tiny incisions in the abdomen, usually of 5-10 mm length. The laparoscope is a surgica.. read more

Laser Laparoscopy

Laser laparoscopy is used to perform a multitude of gynaecologic operative procedures in the treatment of pelvic pain, painful periods and infertility. It has been used around the world and in Aus.. read more

Endometriosis

Endometriosis is a very common cause of pelvic pain and can also cause infertility. It can lead to quite a debilitating illness in some women, causing severe scarring and damage to pelvic or.. read more

Fibroids

Fibroids are benign growths in the uterus which can be tiny or very large. They are often multiple, and result in enlargement and distortion of the uterus. They are quite common. There are 4 types.. read more

Advanced Hysteroscopic Surgery

Dr Marshall was one of the first surgeons to perform endometrial ablation (http://www.drbrettmarshall.com.au/treatment/endometrial-ablation) in Australia and is recognized as a subspecialist in ad.. read more

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