Diagnosing Chronic Pelvic Pain
Procedures Used to Diagnose Chronic Pelvic Pain
If imaging tests don't reveal the cause of your pelvic pain, a procedure called laparoscopy may be recommended. It involves inserting a camera or scope through a small incision to look at the pelvic organs or take tissue samples. Also, a hysteroscopy, a small camera placed through the vagina into the uterus, may be useful to diagnose abnormalities that may cause pain originating inside the uterus.
"Pain mapping" is a technique some doctors use. While you're sedated but awake, a doctor uses a laparoscope and a probe to stimulate points inside your pelvis. You rate any pain you feel and say whether it is like the pain you typically experience. This creates a "map" of sensitive areas.
The Role of a Urologist
A urologist is another specialist whom you might see if pain is related to your urinary tract. For example, if your symptoms and pelvic exam suggests interstitial cystitis (IC), there are tests that a urologist can do. IC is painful bladder inflammation that isn't caused by an infection.
A cystoscopy is one way to diagnose interstitial cystitis. Using a special scope, the doctor looks inside your bladder for bleeding or ulcers. The potassium sensitivity test is another way to diagnose it. For this, the doctor fills your bladder with a potassium solution and then with water. People with IC feel more pain and a more urgent need to urinate with potassium than with water. But doctors may diagnose interstitial cystitis without these tests if you have symptoms of IC and no other pelvic problems.
The Role of a Gastroenterologist
Some women with pelvic pain may need to see a gastroenterologist, a doctor who specializes in digestive diseases. That's because irritable bowel syndrome (IBS) is a common cause of pelvic pain. It may be the only cause or it may exist with other causes.
Usually doctors diagnose IBS based on symptoms you describe. Tests can rule out other diseases if the doctor thinks that something else may be wrong.
The Role of a Pain Specialist
Pain specialists are usually anesthesiologists who have specialized training in pain management. Some women with chronic pelvic pain can seek out these physicians to complement treatment provided by their primary care or gynecologist. Pain specialists may be necessary for appropriate trials of nerve blocks, the use of transcutaneous electrical nerve stimulation (TENS) units, or management of medications used for chronic pain.