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Causes of Pelvic Pain

Clinical Evaluation of Pelvic Pain
  • Approach to the Patient
     with pelvic pain

  • History
  • Physical Examination
  • Laboratory Tests
  • Laparoscopy and
     Hysteroscopy

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How Can I help You?

Dr Eric Daiter has tremendous experience in the diagnosis and treatment of persistent pelvic pain. If you are not getting effective care for your pelvic pain, Dr Eric Daiter is happy to help you (in the office or on the telephone). It is easy, just call us at 908 226 0250 to set up an appointment (leave a message with your name and number if we are unable to get to the phone and someone will call you back).

Availability

"I always try to be available for my patients since I do understand the pain and frustration associated with fertility problems or endometriosis."

Cost

"I understand that the economy is very tough and insurance companies do not cover a lot of the services that might help you. I always try to minimize your out of pocket cost while encouraging the most successful and effective treatments available."

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The patient history should include the patient’s own report of the pain (what she noticed about the pain, when the pain started, what makes the pain better or worse, where the pain is located and where does the pain radiate) as well as a directed set of questions. The basic questions that physicians ask elicit information on

  1. location of pelvic pain (“where does it hurt?” and “does the pain move or radiate from one spot to another?”) which may involve drawing pain sites on a map or pointing to the sites where the pain is most severe;
  2. severity of pelvic pain (“how bad is the pain?”) which may be ranked on a scale (say from 0-10 with 10 being the worst possible pain that you can imagine), described as interfering with certain functions (“wakes me up from sleep,” “stops me in my tracks,” “I no longer enjoy my life,” or “makes working at my job impossible”), or quantified by how much pain medication is required for relief (pain medication is needed rarely, regularly or is ineffective);
  3. events that affect the severity of pelvic pain (“what makes the pain better or worse?”) with open ended questions like sitting, bending, lifting, stretching, standing, lying down, warm compresses, cold compresses, and with a focus on reproductive events (menstrual flow or intercourse), bowel function (bowel movements or gas), and bladder emptying (voiding);
  4. type or quality of pelvic pain (“how can you describe the pain?”) that can be sharp, cutting, burning, searing, stabbing, pricking, shooting, throbbing, pounding, annoying, unbearable, dull, aching, sore, tiring, exhausting, sickening, crushing, pressing, tugging, pulling, or “killer”
  5. timing of pelvic pain (“when did you first notice the pain and has it changed since then?”) including whether the pain has expanded to involve a larger area since it first presented and if there were any identifiable factors that may have caused the pain (after being hospitalized for a severe infection or after a motor vehicle accident); and
  6. prior medical evaluations or treatments for the pelvic pain

The “chronic pain syndrome” describes situations in which a person develops abnormal emotional or behavioral qualities in response to long-term pain. This is a significant problem that is very difficult to effectively treat. Diagnostic criteria for chronic pain syndrome vary somewhat, but generally include pain for greater than 3 months duration, pain that is out of proportion to identified pathology, reduced physical activity at home or work (stopped walking up stairs, running, or playing sports), signs of depression (early morning awakening, feeling hopeless, difficulty making decisions, or lacking energy), and abnormal emotional or family roles (difficulty supervising or disciplining children, unable to nurture partner, difficulty making major family decisions). When a chronic pain syndrome develops then early intervention, evaluation and possibly coordination of treatment with a psychologist or psychiatrist may be very helpful.



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