Chronic Female Pelvic Pain - Surgery

Surgery may be used in the diagnosis or treatment of chronic pelvic pain. It is most likely to be effective when it is performed for a specific condition, such as fibroids or endometriosis.

There is no evidence that surgical removal of the reproductive organs relieves chronic pelvic pain.³ When surgery, such as hysterectomy or cutting of specific pelvic-area nerves, is done for pain with no known cause, there is a risk of persistent pain or pain that is worse after surgery as well as surgery-related side effects.

Surgery Choices

Either laparoscopic surgery through a small incision or laparotomy through a larger abdominal incision can be used for procedures to treat pelvic pain.

Hysterectomy, the surgical removal of the uterus, is sometimes used as a last-resort treatment for chronic, severe pelvic pain. Depending on the cause, hysterectomy may relieve pain for some women.
Studies have shown that surgery to remove scar tissue adhesions from previous surgery or from pelvic inflammatory disease does not relieve pain unless the adhesions are severe (referred to as stage IV adhesions).²

What To Think About

Laparoscopy to diagnose chronic pelvic pain may be done before treatment with medications (other than birth control pills) or surgery. Sites of endometriosis (implants) or scar tissue (adhesions) may be removed or destroyed during the laparoscopy.⁴

Hysterectomy is only a good treatment choice for chronic pelvic pain when a documented disease or surgically correctable condition of the pelvic organs is present. When hysterectomy is performed solely for relief of pelvic pain, the results may be disappointing.

Surgery may lead to complications that cause added pain, discomfort, or other problems such as infection or scar tissue.

Symptoms caused by chronic pelvic pain often go away without treatment when menopause occurs and hormone fluctuations settle down. Controlling symptoms with home treatment or medications until menopause may be an option. Symptoms of chronic pelvic pain may return if you decide to use hormone replacement therapy for perimenopausal symptoms. Discuss your options with your health professional if you are nearing menopause.

WebMD Medical Reference from Healthwise

Last Updated: January 28, 2009

This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

Chronic Female Pelvic Pain Topics

Bladder Control Problems?
Have a Life Less Interrupted

Important Safety Information | Prescribing Information

ENABLEX is a prescription medicine used in adults to treat the following symptoms due to a condition called overactive bladder:

· having a strong need to go to the bathroom right away (also called "urgency")
· leaks or wetting accidents (also called "urinary incontinence")
· having to go to the bathroom too often (also called "urinary frequency")

IMPORTANT SAFETY INFORMATION

You should not take once-daily ENABLEX if you have certain types of stomach problems, glaucoma, or have trouble emptying your bladder. Side effects of ENBLEX include blurred vision, and more commonly dry mouth, constipation, indigestion, and abdominal pain. Use caution when doing certain activities until you know how ENBALEX affects you.

As You Journey through Menopause, Vivelle-Dot Is By Your Side

VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRPTION ONLY.

INDICATION

Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.

IMPORTANT SAFETY INFORMATION

Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).

Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).

Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.

The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.

You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please see Full Prescribing Information for Vivelle-Dot.

Prescribing Information