Pelvic pain causes: Difference between revisions
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| Line 89: | Line 89: | ||
== Treatment == | == Treatment == | ||
*Positive pregnancy test | *Positive [[pregnancy]] test | ||
:*Determine LMP | :*Determine LMP | ||
:* | :*Confirm intrauterine [[pregnancy]] | ||
=== Acute Pharmacotherapies === | === Acute Pharmacotherapies === | ||
*Endometriosis | *[[Endometriosis]] | ||
:*Oral contraceptives 3-4 months | :*[[Oral contraceptives]] 3-4 months | ||
:*Provera 39mg QD/2 months | :*[[Provera]] 39mg QD/2 months | ||
:*Danazol 200-800mg QD/6 month | :*[[Danazol]] 200-800mg QD/6 month | ||
:*GnRH agonist | :*[[GnRH agonist]] | ||
*Primary dysmennorhea | *[[Primary dysmennorhea]] | ||
:*Oral contraceptives | :*[[Oral contraceptives]] | ||
*Treat STD's accordingly | *Treat STD's accordingly | ||
Revision as of 03:12, 31 January 2013
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.
Causes
Causes 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 luteal 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 and pelvic exam - speculum, bimanual, rectal
Other
- Examine for signs of physical abuse
Laboratory Findings
- Labs include:
- Urine pregnancy test
- Urinalysis
- Gram stain and 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
- Oral contraceptives 3-4 months
- Provera 39mg QD/2 months
- Danazol 200-800mg QD/6 month
- GnRH agonist
- Treat STD's accordingly