Surgery for Pelvic Pain
Surgery for pelvic pain is considered when conservative treatments have not provided relief or when a specific underlying cause of the pain can be identified that requires surgical intervention. Pelvic pain can have various causes, and the surgical approach depends on the diagnosis and the underlying condition contributing to the pain.
Common Surgical Procedures for Pelvic Pain:
Laparoscopy:
Laparoscopic surgery, also known as minimally invasive surgery, involves making small incisions in the abdomen to insert a camera (laparoscope) and surgical instruments. This technique can be used to diagnose and treat various conditions causing pelvic pain, such as endometriosis, ovarian cysts, and adhesions. Laparoscopy is often preferred because it typically results in shorter recovery times and less scarring compared to traditional open surgery.
Hysterectomy:
In cases where pelvic pain is related to conditions such as uterine fibroids, adenomyosis, or chronic pelvic inflammatory disease, a hysterectomy (removal of the uterus) may be recommended. Depending on the situation, a total hysterectomy (removal of the uterus and cervix) or a partial hysterectomy (removal of the uterus while preserving the cervix) may be performed.
Ovarian Cystectomy:
If the pelvic pain is due to ovarian cysts, a cystectomy may be performed to remove the cyst while preserving the ovary. This is a common procedure for benign cysts.
Salpingo-Oophorectomy:
In some cases, the removal of one or both ovaries and fallopian tubes may be necessary to address conditions like ovarian torsion, chronic infection, or ovarian tumors.
Lysis of Adhesions:
Adhesions are abnormal bands of scar tissue that can cause pelvic pain by restricting movement and organ function. Surgical lysis of adhesions involves cutting or removing these bands to alleviate pain and restore normal organ mobility.
Uterosacral Ligament Suspension:
This procedure may be considered for women with pelvic pain caused by uterine or vaginal prolapse. It involves repositioning and attaching the uterus or vaginal apex to the uterosacral ligaments for added support.
Endometriosis Excision:
In cases of severe endometriosis, surgical excision of endometrial tissue can provide relief from pelvic pain. This may be performed using laparoscopic techniques.
Nerve Block or Neuromodulation:
In some instances, surgical procedures may involve blocking or modulating specific nerves in the pelvis to relieve pain. Sacral neuromodulation is one example of such a procedure.
It’s important to note that surgery is typically considered after a thorough evaluation and discussion with a gynecologist or a healthcare provider specializing in pelvic pain. Not all cases of pelvic pain require surgery, and conservative treatments, such as physical therapy, medication, lifestyle modifications, or pelvic floor exercises, may be effective in managing pain for many individuals. The choice of surgical procedure and the risks and benefits associated with it should be thoroughly discussed with Dr. Jeffrey Kotzen to make an informed decision about treatment.