Raleigh Gynecologist - When to see your doctor about pelvic pain

All women feel some pain or discomfort in the lower abdomen from time to time, for instance, before or during menstruation. In most cases the pain is familiar, however when the circumstances change it may be difficult to identify the cause(s) of the pain. Noting certain features about your discomfort however may help you and your doctor come to a likely diagnosis.

Common causes of pelvic pain can include a urinary disorder such as a bladder or kidney infection, a bowel problem, or a condition involving the reproductive system – uterus, Fallopian tubes or ovaries.

In Raleigh Gynecologists regularly treat pain related to the urinary system which can indicate such conditions as cystitis (inflammation of the bladder), inflammation of the kidneys (pyelonephritis), kidney stones, or uncommonly tumors.

Usually kidney stones are associated with severe pain. The possibility of infection is often increased by the presence of blood in the urine or could even signal a bladder or kidney tumor. The presence of blood in the urine always requires further investigation and should be reported to your doctor immediately. You should also take note of the duration of the pain. That could also help doctors in finding the correct diagnosis.

Sometimes uterine fibroids are the cause of pelvic pain, in addition to heavy or irregular uterine bleeding. Uterine fibroids, also called leiomyomas, are noncancerous tumors of the uterus (less than 1% are cancerous). Fibroids are the most common solid pelvic tumor in women. They are usually detected in women in their 30's and 40's. After menopause, fibroids may shrink due to lack of estrogen.

Surgery for uterine fibroids may involve removal of the fibroids (myomectomy) or removal of the uterus (hysterectomy). If myomectomy is chosen, the surgery may be performed by laparoscopy, hysteroscopy, or through an open abdominal incision. Removal of a submucosal fibroid is performed using advanced hysteroscopy. Usually, a small wire acts as a scalpel to shave pieces of the fibroid until it is completely removed. Intramural fibroids may be removed using the laparoscope or hysteroscope.

In Raleigh Advanced laparoscopy allows removal of subserosal fibroids while minimizing the size of abdominal incisions. If the surgery is performed laparoscopically or hysteroscopically the patient will usually go home the day of surgery. If a larger abdominal incision is made, patients will often stay overnight. There is a recurrence risk with myomectomy unlike hysterectomy.

Acute and sudden pains are always worrying but chronic pain can also have serious implications and a doctor should be consulted. Your doctor will ask you a few routine questions about periods, passing of urine and bowel movements. They might also ask about other symptoms including episodes of nausea, vomiting, or fever. If appropriate, they may also ask questions concerning your personal life - family, friends, work - and your sex life.

Most likely, after the Q&A your doctor will need to examine you. This will involve feeling your abdomen and, in addition, an internal examination (vaginal, rectal or sometimes both) may be necessary. Further investigations or treatment will be based upon the description of the pain and the findings of the doctor's examination.

Your doctor may deem it necessary to acquire a urine sample to test for any signs of infection.

If a kidney problem is suspected than an ultrasound scan of the kidneys and bladder will be arranged. It is important to ask your doctor questions and be completely truthful during his or her examination. This can help in determining the cause of your pelvic pain and is essential to finding the appropriate treatment.