Pelvic Pain Flashcards
What is a general ddx for pelvic pain?
- Cyclic pain: Follows a pattern that relates to phase or time of cycle.
- Examples: Mittelschmerz , Endometriosis, Dysmenorrhea
- Non cyclic- random, related to non menstrual events/activites/functions
- Interstitial cystitis, Diverticulosis, or a Hernia
What ddx with menstual related pain?
Endometriosis
Adenomyosis
Mittelschmerz (pain with ovulation)
Post Ablation Syndrome (collection of menstrual fluid behind scar)
Leiomyoma
What is an ovarian remnant?
ovarian tissue regenerates or grows in response to gonadotropins
May be seen as a cyst or mass, increased estradiol levels in bilateral ovarian removal
More frequent on the left side.
What is the most common reason for cyclic pain?
ovarian cysts
Why can it be difficult to dx tubal or paratubal cysts?
hard to distinguish on imaging
*most tubal issues are due to obsturction: hematosalpinx (blood), pyosalpinx (pus), hydrosalpinx (fluid)
What is pelvic congestion?
presence of dilated veins in the pelvis
seen in broad ligament
central, deep pain often after veigous activity, standing, intercourse or menses
What is a defect in the protective layer of the bladder?
interstitial cystitis
have dec bladder volume bc it gets stiff
What is the most common hernia in women?
indirect inguinal
What are the ABCs of pelvic pain?
• A Adenomyosis
- B Bacteroides/abscess
- C Coelomic metaplasia
- D Diverticular disease
- E Ectopic Pregnancy
- F Fallopian tube filling (Hydro/Pyo/PID)
- G Gardnerella or ascending infection
- H Haemophillus and endometritis
- I Illeus
- J Jejunum
- K Kancerous changes (cheated)
- L Leiomyoma
- M Mittelschmerz
- N Novasure and post ablation syndrome
• O Ovulation and ovarian cyst
- P Primary dysmenorrhea
- Q Quit contraception/pregnancy
- R Retrograde menstruation
- S Sexually Transmitted Infection
- T Torsion of Ovary
- U Ulcerative Colitis/Inflammatory Bowel disease
- V Vascular Congestion
- W Water blockage (bladder or ureter)
- X eXuberant adhesions
- Y Yucky bugs
- Z ( for Z plasty) Adhesions and their issues- hernia, infection, nerve entrapment.
