Pelvic Pain
Surgery
Surgery as a treatment for chronic pelvic pain is controversial. This is because most surgical procedures for the diagnosis and treatment of chronic pelvic pain have been limited in their success.
During this surgery, the uterus and/or fallopian tubes and ovaries are removed. Of all hysterectomies done in the United States, about 12% (about 60,000 women each year) are done to treat chronic pelvic pain. Success rates, which some experts believe are exaggerated, range from 60% to 95%. Researchers have found that one in every four women had some pain one year after having a hysterectomy. Another group of researchers showed that 40% of women who have had a hysterectomy will have continued chronic pain.
During this procedure, tiny tools such as cameras, lasers and/or blades are inserted into several small incisions (cuts) in your abdominal/pelvic area. Examples of laparoscopic procedures for chronic pelvic pain include:
These are done to destroy the nerves that may be causing your chronic pelvic pain. Examples of these procedures include uterosacral nerve ablation and presacral neurectomy. Transcatheter embolization of the ovarian veins is a procedure during which abnormal blood vessels are clotted off. This may help people who have pelvic congestion syndrome and pain during sexual intercourse.
The sacrum is part of your lower back. Sacral neuromodulation is a type of electrical stimulation, or “neurostimulation” to the sacrum. It is an FDA-approved treatment of refractory interstitial cystitis and urgency incontinence. Because pain is a major symptom of interstitial cystitis, sacral neuromodulation has proven to be effective in decreasing pain.
Implantable Technologies: Spinal Cord Stimulation and Implantable Drug Delivery Systems
Hysterectomy
During this surgery, the uterus and/or fallopian tubes and ovaries are removed. Of all hysterectomies done in the United States, about 12% (about 60,000 women each year) are done to treat chronic pelvic pain. Success rates, which some experts believe are exaggerated, range from 60% to 95%. Researchers have found that one in every four women had some pain one year after having a hysterectomy. Another group of researchers showed that 40% of women who have had a hysterectomy will have continued chronic pain.
Laparoscopy
During this procedure, tiny tools such as cameras, lasers and/or blades are inserted into several small incisions (cuts) in your abdominal/pelvic area. Examples of laparoscopic procedures for chronic pelvic pain include:
- Cutting (“lysis” of) adhesions
- Removing endometrial tissue that grows outside the uterus either with laser or electric current (“ablation” or “fulguration”)
- Destroying the uterosacral nerve by ablation (burning the ligaments that attach the uterus to the sacrum, which is a part of the pelvic bone) – pelvic bone or spine.
- Pelvic pain mapping
Neuroablative Procedures
These are done to destroy the nerves that may be causing your chronic pelvic pain. Examples of these procedures include uterosacral nerve ablation and presacral neurectomy. Transcatheter embolization of the ovarian veins is a procedure during which abnormal blood vessels are clotted off. This may help people who have pelvic congestion syndrome and pain during sexual intercourse.
Sacral Neuromodulation of the Third Nerve Root
The sacrum is part of your lower back. Sacral neuromodulation is a type of electrical stimulation, or “neurostimulation” to the sacrum. It is an FDA-approved treatment of refractory interstitial cystitis and urgency incontinence. Because pain is a major symptom of interstitial cystitis, sacral neuromodulation has proven to be effective in decreasing pain.
More Information
Implantable Technologies: Spinal Cord Stimulation and Implantable Drug Delivery Systems