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Pelvic Floor Dysfunction

The cause for pelvic pain is often difficult to diagnose. Tissues around the pelvic organs might suffer increased or reduced sensitivity or irritation leading to pain in the area. Pelvic floor disorders can manifest as urinary incontinence or fecal incontinence. Typical pelvic disorders include interstitial cystitis, pelvic inflammatory disease or digestive disorders such as diverticulitis and colitis. Cystitis, irritable bowel syndrome, pelvic congestion and Vulvovaginitis> are other pelvic conditions that lead to pelvic pain. Infections, pregnancy and childbirth, incorrect posture, trauma or surgery can lead to pain in the pelvic area.


Symptoms in Women


  • Frequent urination with incomplete sensation
  • Pelvic pain
  • The feeling of incomplete bowel movement
  • Vaginal or rectal prolapse (sagging of the vagina or rectum)
  • Rectocele (protrusion of the rectum into the vagina)
  • Cystocele ( herniation of the bladder into the vagina)
  • Enterocele (a herniation of the intestine into the vagina)
  • Sigmoidocele (a herniation of the sigmoid colon into the vagina)


Symptoms in Men:


  • Urgency and frequency in urination
  • Pain in testes and pain on ejaculation
  • Reduced urinary flow
  • Levator Ani Syndrome (pressure and pain in the sacrum)
  • Constipation or strain during bowel movement

For constipation, low dose muscle relaxants are prescribed. Lifestyle changes in diet and physical activity are recommended. Rectal prolapse and rectocele may be treated through surgery. Cold laser involving a process wherein low-intensity laser light is applied to the tissue easing the pain and inflammation.


Ovarian Cystic Disease

Ovarian cysts are fluid-filled sacs that often form during the course of a menstrual cycle. Ovarian cysts form on or in the ovaries. Usually ovarian cysts are harmless and do not cause much discomfort. Most ovarian cysts form when the follicles are not reabsorbed by the body and instead persist and form cysts. While most ovarian cysts are resolved sans any treatment, some cysts may need to be attended to. Rarely are ovarian cysts life threatening; unless there is danger of rupture and internal bleeding. Most often ovarian cystic disease is benign. A woman suffering from ovarian cystic disease may experience dull pelvic pain, menstrual irregularities and pain during intercourse. If there is any sudden pelvic pain accompanied by vomiting or fever, it is imperative to see a doctor at once. Polycystic Ovarian Syndrome (PCOS) is a condition where there multiple cysts lead to metabolic dysfunction. It manifests in symptoms such as obesity, infertility, acne and excessive body hair.


A pelvic examination and ultrasound will reveal presence of ovarian cysts. Hormone levels are tested for abnormalities. A CAT scan or MRI scan can also aid in diagnosing ovarian cysts. Often ovarian cysts may not need any active treatment. The treatment for ovarian cystic disease hinges on the size of the cysts, its growth pattern and the age of the woman. Use of birth control pills is sometimes recommended to reduce the size and symptoms of ovarian cystic disease. Laparoscopy is used to study the ovarian cysts and sometimes remove them. Cystectomy is the surgical procedure to remove the ovarian cysts without removing the ovary. This done for cysts that persist for more than a few months and grow larger than 6 cms in size. A woman can reduce the chances of ovarian cystic disease with healthy diet and fitness regimen, thereby improving overall health condition.


Endometriosis

Endometriosis affects nearly 10% of women during their reproductive years and is a major cause for infertility. This gynecological condition occurs when the tissue lining the uterus (endometrium) grows outside the uterus. The endometrium then grows on the ovaries, fallopian tubes and outer surface of the uterus and even sometimes on the bladder, bowel, intestines, colon, vagina, cesarean and laparoscopy scars. This endometrial growth does not get regularly sloughed off with the menstrual cycle and keeps building up to form ovarian cysts. In fact endometriosis can even cause distortion of a woman's internal anatomy. While the theory of retrograde menstruation holds that some menstrual blood flows back through the fallopian tubes and grows there, it is not yet fully substantiated yet. Some women have a genetic predisposition to endometriosis. The role of immune system dysfunction and environmental influence on endometriosis is also being studied.


Severe pelvic pain is the characteristic symptom associated with endometriosis. This pain is felt while passing urine, during sexual intercourse and during ovulation. A woman suffering from endometriosis may notice heavy irregular bleeding and abdominal bloating. Infertility is noticed in more than 40% of women suffering from endometriosis. A pelvic examination is conducted on a woman complaining of symptoms of endometriosis. It can reveal the presence of tender nodules in the ovary regions or the posterior vaginal wall. Pelvic ultrasound is used to locate endometriosis areas. Laparoscopy can aid in checking pelvic organs for endometrial tissue. It gives a clear idea of the extent and location of endometriosis.


Hormone therapy is advocated by some as treatment against endometriosis. Birth control pills or progestins are often prescribed. This may help in tempering the estrogen production and relieving some of the signs and symptoms of endometriosis. Progesterone pills or injections can be used to treat endometriosis. The drug Danazol is also sometimes prescribed. Anti-gonodotropins produce a psedomenopausal state and can relieve some of the problems associated with endometriosis. But treatment of endometriosis with drugs is limited to about six months or so to prevent a detrimental effect on bone density. Laparoscopic surgery is yet another endometriosis treatment advocated by some doctors. The surgeon aims at removing all endometriosis lesions, cysts and adhesions. This is done is severe cases of endometriosis and infertility.

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Bibliography / Reference

Collection of Pages - Last revised Date: November 22, 2019