Pain is always real, but it is not always easily diagnosed. Most times the cause of pain can be determined, and most of those times, we can get pain relief. For those times when we cannot determine the cause of the pain, what you really need is what the pain is not due to.
Is the condition serious? Is the condition surgical? Is the condition related to pregnancy? These are questions we can answer.
Pelvic pain is not always due to endometriosis but when it does not respond to oral contraceptives and anit-inflammatory pain medications, then laparoscopy is indicated. If there is no pathology, if the pain is not due to endometriosis, then you may not get any pain relief from laparoscopic excision surgery.
Studies have been done where small laparoscopes are placed in the abdomen of awake patients and different areas are touched to see where the patient feels pain, and where the pain radiates to, and this is called Conscious Sedation Pain Mapping. Touching the pelvic sidewall sends pain into the hip, groin, and down the leg. Touching the uterosacral ligaments (from the cervix, around both sides of the rectum, to the sacrum) sends pain to the lower back, tail-bone, and rectum.
Surgical intervention is only done for 2 reasons: Severity and Concern.
Severity is when the pain is so bad you cannot continue to live with it. Severity is when you are not meeting your responsibilities at home or work.
Concern is a combination of one or more of 4 things:
- concern over the amount of medication you are taking;
- concern about missing the diagnosis of something serious like malignancy;
- concern about future fertility; or
- concern about quality of life and wanting to try to do something to feel better.
To inquire about diagnosing your condition or managing your pelvic pain, please contact Dr. Robbins using the form below.