Monterey Pelvic Medicine and Pain Management

Chronic pelvic pain

SURGERY IS NOT ALWAYS THE ANSWER

Persistent and recurrent pelvic pain, although prevalent, remains elusive to accurately diagnose and treat.  Until recently, the role of peripheral nerves and muscles were underestimated with concentration on pelvic organs removal to alleviate pelvic pain. This has been disappointing and frustrating to many clinicians and often quality-of-life altering for their patients. Understanding and diagnosing the neurological pathway of pain with newer available modalities and available treatment has helped in managing this stubborn condition.

CHRONIC PELVIC PAIN PRESENTS AS PERSISTENT,RECURRENT PAIN THAT CAN BE SPONTANEOUS OR TRIGGERED BY EVENT(S) SUCH AS :

Pain in vulva, vagina, perineum, or anus

Pain following sex (Dyspareunia)

Painful periods (Dysmenorrhea)

Painful urination, urinary hesitancy, urgency, and/or frequency

Abdominal and groin pain

Sacroiliac joint pain/instability

Painful defecation (constipation)

Pain with sitting

Clitorodynia (pain is centered around the clitoris. It can be burning, sharp or dull pain that often limits clothing choices, time in sitting, biking and sex)

Tailbone pain/coccydynia

CHRONIC PELVIC PAIN CAN BE CAUSED BY ANY OF THESE MEDICAL CONDITIONS:

Adhesions – scar tissue between the internal organs in the pelvic cavity

Interstitial Cystitis/painful Bladder Syndrome

Vulvodynia/vestibulitis/Clitorodynia (Irritation, inflamation, pain of Vulva and Vaginal entrance or Clitoros)

Persistent Genital Arousal Disorder (PGAD, unrelenting, spontaneous and uncontainable often painful genital arousal. The patient’s arousal is not linked to sexual desire.)

Endometriosis

Irritable Bowel Syndrome (IBS)

Pelvic girdle pain (occurs in the front or back of the pelvis. This is known as pelvic girdle pain or PGP)

Sacroiliac joint dysfunction

Pudendal Nerve neuropathy and related conditions.

Comprehensive diagnostic evaluation is necessary to sort out the exact causes of this difficult condition. It might be necessary to spend multiple sessions and testing to reach the correct conclusion and manage accordingly.

Evaluation Treatment Plan