Chronic pelvic pain can be defined as severe discomfort in the pelvic area occurring for more than six months. Pelvic pain or pain in pelvic organs may occur due to various underlying conditions such as endometriosis. The discomfort can be caused by other body conditions as well, treating which may reduce the pain. However, if the pain occurs due to an ailment related to pelvic organs, the treatment may include hysterectomy surgery. The surgery may be the final resort for the surgeons to reduce severe pain and improve quality of life. It is necessary to note that hysterectomy surgery will lead to immediate menopause and slight discomfort after the procedure.
Symptoms of Chronic Pelvic Pain
Chronic pain in the pelvic organs may be spread across the pelvis or a specific point. The pain around the pelvic area or in pelvic organs is defined in the following ways:
- Intermittent pain
- Dull aching
- Steady and severe pain
- Cramping or sharp, pinching pain
- Heaviness or deep discomfort in the pelvis
In addition to this, it is common for individuals to experience pelvic pain at the time of:
- Urinating or bowel movement
As the underlying condition may be different in different individuals, the discomfort experienced is also varied. For instance, some women may feel discomfort while standing or lying down. The pelvic pain can be mild and constant or severe and intermittent. However, when the symptoms start interfering with the quality of life, it is necessary to consult a doctor for further diagnosis and the right treatment option, such as hysterectomy surgery.
Causes of Chronic Pelvic Pain
Chronic pain in pelvic organs is a complicated condition which may be caused due to various reasons. For instance, inflammatory infection in pelvic which may be transferred through sexual intercourse. Common causes of chronic pelvic pain, which may need hysterectomy include-
Endometriosis is a condition in which the tissues present on the uterus lining start growing outside the uterus. Although the tissue deposits react similarly to uterus lining, there is no path to exit the body through the vagina. The tissues thicken, break down, and bleed in congruence to the inner uterus lining. However, the body is unable to shed the tissues which leads to accumulation in the abdomen. This may trigger the formation of fibrous bands and cysts.
Abnormal Uterine Bleeding (ABU)
In severe cases, abnormal uterine bleeding or AUB can lead to chronic pelvic pain. The gynecologist will suggest the most suitable treatment option for AUB to the female, depending on her age and current health conditions. Hysterectomy in such cases might improve the female’s quality of life.
Uterine fibroids are noncancerous uterine growths that may cause pressure or feel like heaviness in the lower abdomen. Uterine fibroids do not generally cause sharp pain. Fibroid growth in the uterus may cause pelvic discomfort and heaviness. When this growth leads to benign tumors, which causes anemia, bleeding, bladder pressure, and pelvic pain, hysterectomy surgery helps in permanently removing the occurrence of tumor. In case no other treatment option works for uterine fibroids and if the female has completed her family, the doctor may suggest hysterectomy.
In advanced cases of uterine prolapse, when no other treatment options have been successful, the doctor may consider hysterectomy if the female has completed her family and is in her 40s. Performing a hysterectomy for uterine prolapse will remove the uterus which is protruding into, or out of the vagina. Uterine prolapse does not result in a serious medical condition, but symptoms of prolapse for a female can be physically and emotionally uncomfortable
Bleeding after menopause
Bleeding after menopause is a serious concern. Pelvic pain is a common symptom of bleeding post-menopause. There can be many possible causes for bleeding after menopause. Endometrial cancer and cervical cancer can also cause bleeding after menopause. Females diagnosed with such cancers or a precancerous form of endometrial hyperplasia might find hysterectomy life-saving.
Chronic Pelvic Inflammatory Disease
During sexual intercourse, it is possible for women to catch the infection, which when left untreated can spread inflammation to pelvic organs. The long-term inflammation in the pelvic area can cause scarring in pelvic organs, which can lead to chronic pain.
If during previous hysterectomy surgery, some ovary remains are left inside the body, it can form cysts in the pelvis causing inflammation and chronic pain.
Why Hysterectomy Surgery?
Chronic pelvic pain may be caused due to various disorders, which is why the examination may involve several tests.
- The pelvic exam checks for signs of inflammation, infection, vaginal growth, or tenderness. On the occurrence of visible signs, the doctor may run some additional tests to find the root cause of the pain.
- For detecting ovary cysts and unwanted masses in the body, ultrasound is utilized. It gives precise images of the ovaries, fallopian tube, and uterus.
- Sometimes, CT scans, MRI, and abdominal x-rays are utilized to closely assess the presence and extent of abnormal growth.
- To check the presence of infection in pelvic organs, laparoscopy uses a thin tube with a camera. Inserting this tube through an adnominal incision in the body helps in detecting inflammation and disorders like endometriosis.
The treatment of chronic pain in women depends on the underlying condition. When the condition can’t be cured through drugs and non-surgical treatments, hysterectomy surgery is considered. The goal throughout the treatment is to reduce discomfort and increase the quality of life.
During the hysterectomy surgery, the uterus, ovaries, and the fallopian tubes are removed and detached from the body. It is necessary to understand the repercussions of hysterectomy surgery before opting for this procedure.
What to Expect?
During hysterectomy surgery, the uterus is detached from the fallopian tube, ovaries, vagina, blood vessels, and connecting tissues. The cervix may or may not be removed depending upon the type of hysterectomy.
According to the underlying condition, other pelvic organs such as fallopian tube and ovaries may also be removed.
Before the surgery, the doctor may suggest the following tests:
- Pap test to detect the presence of cervical cancer or abnormal growth.
- Pelvic ultrasound to observe cysts and fibroids.
- Endometrial biopsy to detect the presence of endometriosis or growth outside the uterus.
During the surgery, the patient would be under the influence of general anesthesia. The procedure will include:
- An incision is made in the vagina to access pelvic organs.
- Using surgical instruments, the uterus is detached from the fallopian tube, ovaries, and connecting tissues.
- The uterus is removed from the incision. Absorbable stitches are utilized to secure the incision and stop the bleeding.
After the surgery, some pain and discomfort may be observed for a few days along with vaginal bleeding. Usually, medication is given to reduce pain and fight unwanted infections. However, it is necessary to monitor signs of infection and severe pain.
After hysterectomy surgery, it takes almost six weeks to return to normal working. It is suggested to take rest but still keeps the body active. In some cases, doctors suggest refraining sexual intercourse for at least six weeks after the surgery.
Before returning to a normal routine, follow the doctor’s recommendations for safe recovery.