Pelvic Pain

What is pelvic pain?

Pelvic pain is pain in the area between the hips and below the navel. Pelvic pain may be experienced by anyone. However, the term “pelvic pain” is most commonly used to refer to female pelvic pain that affects the pelvic bones, soft tissues, and/or pelvic organs. Pelvic pain may be due to common conditions, such as menstruation, or may signal disease, infection, or abnormalities such as:

• Appendicitis
• Urinary tract infections
• Sexually transmitted disease
• Kidney or bladder stones
• Diverticulitis or colitis
• Ectopic pregnancy
• Ovarian torsion
• Fibroids
• Endometriosis
• Pelvic floor dysfunction
• Cancer

How is pelvic pain diagnosed and evaluated?

Your doctor may use blood and lab tests as well as imaging tests to diagnose the cause of your pelvic pain. Imaging tests may include:

• Abdominal X-ray uses a tiny dose of ionizing radiation to produce pictures of the inside of the abdominal cavity. It is mainly used to assess dilatation of the gastrointestinal tract. Abdominal x-ray’s speed and ease of use make it useful in emergency diagnosis and treatment. Some providers may refer to an abdominal x-ray by using the dated name “KUB,” which stands for kidneys, ureters, and bladder.  
• Abdominal & Pelvic CT is useful in identifying kidney stones, their related complications, and other causes of abdominal pain such as appendicitis and diverticulitis. It is also useful in assessing a wide variety of cancers involving abdominal or pelvic organs. CT scanning is fast, painless, noninvasive, and accurate. In emergency cases, it can reveal internal injuries and bleeding quickly enough to help save lives.
• Abdominal Ultrasound produces pictures of the structures within the upper abdomen. It is used to help diagnose pain and evaluate the kidneys, liver, gallbladder, bile ducts, pancreas, spleen, and abdominal aorta. Ultrasound is safe, noninvasive and does not use ionizing radiation.
• Pelvic Ultrasound produces pictures of the structures within the lower abdomen and pelvis. There are three types of pelvic ultrasound: transabdominal, transvaginal, and transrectal. These exams evaluate the reproductive and urinary systems. Doctors perform transvaginal ultrasound very much like a gynecologic exam. The doctor will insert the transducer into the vagina after you empty your bladder. The tip of the transducer is smaller than a standard speculum. The doctor places a protective cover over the transducer, lubricates it, and inserts the transducer into the vagina. Transvaginal ultrasound typically provides the highest quality images of the uterus and ovaries but can be difficult to tolerate for some women and may also be challenging in young women (especially those that have never had a speculum exam, transvaginal intercourse, or used a tampon).
• Pelvic Floor MRI produces pictures of the pelvic floor, a network of muscles that stretches between the public bone and the spine as well as the abdominal organs it supports. Pelvic Floor MRI is useful in diagnosing pelvic floor disorders such as organ prolapse, incontinence, pelvic pain, and constipation.

How is pelvic pain treated?

Treatment of pelvic pain will depend on the underlying cause. If kidney or bladder stones are the cause, you may need urology treatment. If your doctor suspects cancer, you may need a biopsy. Cancer treatments may include chemotherapy, surgery or radiation therapy.

Which test, procedure or treatment is best for me?

• Acute Pelvic Pain in the Reproductive Age Group
• Postmenopausal Acute Pelvic Pain
• Pelvic Floor Dysfunction in Female Patients
• Fibroids
• Second and Third Trimester Vaginal Bleeding