Pelvic pain causes: Difference between revisions
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Revision as of 14:52, 20 August 2012
| Pelvic pain causes |
Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pain in the pelvis can be described as acute or chronic. Urologic, gastrointestinal and gynocologic problems can all be possible.
Differential diagnosis of causes of pelvic pain
In alphabetical order: [1] [2]
Acute (<6 months)
- Abdominal Aortic Aneurysm
- Cervicitis
- Diverticulitis
- Ectopic pregnancy
- Endometriosis
- Incomplete abortion
- Intra-uterine device
- Irritable Bowel Syndrome
- Midcycle ovulation
- Mesenteric ischemia/infarction
- Nephrolithiasis
- Ovarian cyst
- Ovarian torsion
- Pelvic Inflammatory Disease
- Pelvic neoplasm
- Pelvic floor prolapse
- Primary dysmenorrhea
- Ruptured corpus lutenal cyst
- Septic abortion
- Sexual abuse/trauma
- Threatened abortion
- Tubo-ovarian abscess
- Urinary Tract Infection
- Uterine fibroids
- Vaginitis
Chronic (>6 months)
- Adenomyosis
- Depression
- Diverticulosis
- Diverticular abscess
- Hernia
- IBD
- IBS
- Interstitial Cystitis
- Leiomyoma
- Lymphoma
- Pelvic adhesions
Diagnosis
History and Symptoms
- Nature
- Sensitivity
- Onset
- Pain occurrence
- intercourse
- menstrual
- chronic vs. acute
- Risk of pregnancy
- Associated symptoms:
Abdomen
- Full abdominal & pelvic exam - speculum, bimanual, rectal
Other
- Examine for signs of physical abuse
Laboratory Findings
- Labs include:
- Urine pregnancy test
- urinalysis
- gram stain & culture
- STD tests
- vaginal smear wet mount
Echocardiography or Ultrasound
- Ultrasound for ovarian cyst, mass, ectopic pregnancy vs. intrauterine pregnancy
Treatment
- Positive pregnancy test
- Determine LMP
- confirm intrauterine pregnancy
Acute Pharmacotherapies
- Endometriosis
- Oral contraceptives 3-4 months
- Provera 39mg QD/2 months
- Danazol 200-800mg QD/6 month
- GnRH agonist
- Primary dysmennorhea
- Oral contraceptives
- Treat STD's accordingly