Chronic Pelvic Pain Services

Chronic Pelvic Pain Services

Do you experienced pelvic pain with every menstrual cycle? Do you experience a dull aching sometimes burning or stabbing pain along the lower part of your abdomen? Do you experience painful intercourse?

Are you tired of seeing many specialists who still have not been able to help with your pain?

The Gynecology & Wellness Center can help, Dr. Melissa A. Delgado is a Chronic Pelvic Pain Specialist which involves evaluating, diagnosing and treating disorders such as Interstitial Cystitis, Endometriosis, Pelvic Floor Dysfunction, Vulvodynia, Chronic Vaginitis, and Irritable Bowel Syndrome.

In addition, chronic pain leads to increased anxiety and depression which can be significantly decreased with pain reduction, acupuncture, and speaking with a therapist who understands anxiety and depression in the context of Chronic Pelvic Pain (CPP).

What is Chronic Pelvic Pain?

Any pelvic pain lasting more than 6 months can be considered chronic pelvic pain.

It may include but is not limited to the following:

  • Painful menses
  • Physical activity is limited due to pain
  • Conventional treatment has not helped relieve the pain
  • Painful intercourse

Chronic Pelvic Pain is a complex issue to solve. If you have Chronic Pelvic Pain, you should know that treating CPP typically requires an ongoing dialogue between patient and physician.

Why is this? Because besides physical issues that may require detailed diagnosis, there are also patterns of muscular use and disuse that patients should be taught to manage their condition.

There may also be psychological issues to work through that require timely feed back from the physician.

Drugs treatments for CPP

To help deal with the pain, patients might be prescribed painkillers and antidepressants used for chronic pain.

These include OTC analgesics like ibuprofen, tricyclic antidepressants such as nortriptyline, and selective serotonin reuptake inhibitors such as Prozac or Paxil.

Physical Therapy

A physical therapist can work with a patient to resolve CPP. A multidisciplinary approach works best. Techniques include heat, massage, stretching exercuses, and ultrasound therapy.

Transcutaneous electrical nerve stimulation is another effective technique, which studies show increases the pelvic pain threshold.

TENS works by what’s called the “gate control” theory of pain. Essentially, putting in non-painful stimulation through the neural “gates” prevents painful stimuli from entering those same gates.

Surgical Options

Surgery options for Chronic Pelvic Pain are minimally invasive. Techniques include injections into painful trigger points, or peripheral nerve blocks using anesthetics or steroids.

In similar fashion, neuroablation can be used to stop pain. Neuroablation is cauterization of a nerve at a specific point to stop pain signalling. Various techniques can be used to achieve neuroablation, including radiofrequency, cryoablation (cold), or chemical methods.

Think you might have Chronic Pelvic Pain? If any of these symptoms sound familiar to you, set up an appointment with Dr. Delgado today to discuss your options.

Even if you are not sure that this applies to you, and you’re interested in finding out more call us to schedule an appointment.


Interstitial Cystitis (IC) or Painful Bladder Syndrome (PBS)

Definition – A chronic inflammatory condition of the bladder wall. Most common symptoms – pain, urinary urgency, urinary frequency.

IC is a chronic condition of the bladder that’s characterized by urinary urgency, frequency and pelvic pain. As mentioned, IC has many symptoms that are in common with other conditions, such as: Chronic Pelvic Pain (CPP), Recurrent Urinary Tract Infections (UTIs), Endometriosis, Overactive Bladder (OAB), and Vulvodynia.

Although more and more doctors are gaining awareness of Interstitial Cystitis (IC), this condition often goes undiagnosed for a long time. And it’s not uncommon for someone with IC to see several doctors, over the course of many years, before they are actually diagnosed with the condition.

That’s why Dr. Melissa A. Delgado and the Gynecology & Wellness Center can help. Dr. Delgado is a Chronic Pelvic Pain Specialist, she understands your pain, frustration and desperation in finding an answer.

Interstitial Cystitis (IC) is a condition better known to most as Painful Bladder Syndrome. Intensity of the condition can range from mild discomfort to extreme pain.

Symptoms of IC include generalized pain in the bladder and the need to urinate frequently. Frequency of urination can be as high as 60 times a day.

Because IC is used to refer to all cases of bladder pain that don’t originate from stones or infections, the pathology of different cases might differ entirely.

Some physicians believe that IC might be a collection of different diseases, rather than simply constituting one condition. Because many diagnosed with IC also have irritable bowel syndrome, some believe that a general inflammatory condition could be behind many cases of IC.

Physical Signs of Interstital Cystitis

In many cases of IC, there is damage to the bladder wall. This can include scarring, pinpoint bleeding, and ulcers.

The symptom of urine frequency could be due to having a small bladder, but this isn’t always the case. Many who suffer from high frequency of urination have normal sized bladders.

Treatment Options for Interstitial Cystitis

There is no clean diagnostic test for Interstitial Cystitis. Instead, the condition is diagnosed simply with the presence of bladder pain and the ruling out of other diseases with similar symptoms.

Because patients diagnosed with Interstial Cystitis specifically do not have urinary infections, and therefore antibiotics tend to be ineffective.

Depending on the pathology, different methods might work to alleviate IC. Bladder Distention and Bladder Instillation can both work to increase the capacity of the bladder.

Dimethyl Sulfoxide is a drug sometimes used to treat IC. Doctors believe its mechanism is blocking inflammation, pain, and contractions in the bladder wall.

It can difficult to tell if you have Interstitial Cystitis or not. Symptoms of the condition are extremely similar to other conditions such as Chronic Pelvic Pain.

If you’re not sure about your condition, it’s important to talk to a physician and a specialist. If you want to find out more, set up an appointment with Dr. Delgado today to discuss your options.


Endometriosis

Definition – A medical condition affecting 5-10% of women suffering from Chronic Pelvic Pain most common symptoms: pelvic pain, painful cycles, painful intercourse, infertility.

If you think you have Endometriosis, or know you have Endometriosis and you still suffer from pelvic pain, make an appointment to talk about it.

Dr. Melissa A. Delgado is a Chronic Pelvic Pain Specialist, and understands how difficult this can be.

Endometriosis is when cells similar to those that line the uterus grow outside of the uterus.

Typically, endometriosis affects the pelvic organs. Usually, endometriosis does not actually cause symptoms, but when it does, women may feel pelvic pain, painful intercourse, painful urination, and even infertility.

Stages of Endometriosis

There are four stages of Endometriosis. Minimal, mild, moderate, and severe. The stages refer to the level to which the abnormal tissue has spread and the presence of scar tissue caused by the abnormal tissue.

Severity of symptoms does not actually directly correspond to the stages of the condition. The exception is infertility, which is associated with the fourth stage of the condition.

The severity of pain might correspond to the presence of the abnormal tissue in areas of high nerve density and the release by the tissue of biological agents which cause pain.

Diagnosing Endometriosis

There is no easy test to diagnose endometriosis, especially because the condition can be asymptomatic.

If someone is displaying symptoms, doctors might use a variety of tests to rule out other conditions and use the symptom patterns to speculate Endometriosis.

But the only sure way to know is through laparascopic examination – a minimally invasive surgery that involves “keyhole” cuts through the abdomen.

Treating Endometriosis

Endometriosis can be treated using a few different pharmacological approaches.

These include nonsteroiodal anti-inflammatory drugs to reduce the pain, Gonadotropin-releasing hormone analogs which can reduce the size of the endometriosis implants, contraceptive pills and progestins for pain relief, and certain androgen (male hormone) producing drugs and aromatase inhibiting (estrogen stopping) drugs which can reduce the size of the abnormal tissue.

Think you might have endometriosis? If you’re not sure, it’s important to find out more.

If you’re struggling with infertility and unable to determine the cause, it’s worth talking to Dr. Delgado to get no. Set up an appointment with Dr. Delgado today to discuss your options.

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