Pelvic pains, even before they become chronic, are pains that affect people’s quality of life negatively, prevent them from continuing their daily life and prevent them from having healthy toilet habits and a healthy sexual life.
Chronic pelvic pain is defined as continuous or intermittent pain between the navel and the pelvis lasting longer than 6 months.
They Can Even Lose Their Lives
Patients can lose their jobs, their partners and, unable to bear these pains, even their lives. These pains can have many different causes. If the pain has arisen because of a condition or a physical problem, it disappears with the treatment of the problem.
If the pain continues for a long time, the person is worn down both physically and mentally. Because of the severity of these pains, marriages and the patient’s work and social life can be very seriously affected. Patients can lose their jobs, their partners and, unable to bear these pains, even their lives because of very severe pain. For this reason it is necessary to look at pelvic pain not as a simple clinical situation but in a very comprehensive way.
Why Does Chronic Pelvic Pain Occur?
Chronic pelvic pain can have many different causes. Endometriosis, also known as the chocolate cyst, is one of the most common problems that cause pelvic pain.
The other forms of the chocolate cyst should also be kept in mind: adenomyosis (the chocolate cyst involving the uterus), endometriosis involving the sciatic nerve and deep endometriosis, which is most often missed in the diagnosis. Deep endometriosis is a very painful clinical situation involving both the urinary tract and the bowels. In deep endometriosis, especially very painful periods, being unable to leave the house during the period, and very painful bowel movements and painful urination are among the complaints that can be seen.
Fibroids, on the other hand, are among the other important causes. Especially fibroids that are located deep, that press on the surrounding tissues and that compress nerves can be the cause of the pain.
The contractions and pains occurring in the pelvic muscles arise as a result of pelvic floor spasm. The pelvic floor muscles hold the organs in the area such as the uterus, the bladder and the rectum. Spasms occurring in these muscles can cause pain of a serious degree.
Interstitial cystitis is also among the causes of pelvic pain arising. Pudendal canal syndrome, sciatic nerve endometriosis, pelvic congestion syndrome, which runs with varicose-type vessels widening around the uterus and the ovaries — rare but treatable once diagnosed — operations performed in the abdominal area and psychological problems can also be among the causes of pelvic pain.
Is the Real Cause of CPP Psychological Problems?
In our country the number of clinicians specialised in CPP is unfortunately very, very small. When the cause cannot be found, after many inadequate treatments and perhaps well-intentioned but unnecessary operations, patients are frequently described as having a psychological cause and are directed to psychiatrists.
In many parts of the world the situation is unfortunately the same. In fact, when the main cause is found, the treatment is simple. Psychological states are unfortunately most often not the cause of prolonged chronic pains but in fact their result.
The Symptoms of Pelvic Pain
Women with chronic pelvic pain can suffer pain to a degree at which they cannot even keep up with the routine of their daily lives. These pains can bring the person to the point of collapse both physically and mentally. Because of the pains, the person’s sexual life is also affected negatively and the balance in their relationship can be turned upside down.
For this reason different techniques must certainly be tried to relieve chronic pelvic pain and the person must regain their quality of life. Besides treatments with different medicines such as painkillers, antibiotics, muscle relaxants and antidepressants, applications such as botox or surgical procedures can be preferred in the treatment of chronic pelvic pain.
But making the diagnosis correctly is the most important issue. In the diagnosis of the condition, neuropelviological assessment is extremely important. In our country there are only 2 specialists in neuropelviology. After a correct diagnosis, CPP can be treated correctly.
How Is Pelvic Pain Treated?
At the basis of the treatment of chronic pelvic pain is what diagnosis has been made in the patient. If the diagnosis is not correct, whatever the treatment, it will most often not work.
Only if a diagnosis cannot be made by any method can the treatment be aimed at relieving the pain. Apart from this, the priority should always be to apply treatments that will eliminate the situation causing the pelvic pain.
If the causes cannot be eliminated, chronic pelvic pain continues and gives rise to problems that will affect the person’s life quite negatively.