Pelvic Pain Flashcards
1
Q
What are the gynae causes of acute pelvic pain?
A
Ectopic peg Miscarriage PID Ovarian cyst - torsion, haemorrhage, rupture Torsion of fallopian tube Salpingo-ovarian abscess Mittelschmerz Primary dysmenorrhoea Acute exacerbation of chronic pain
2
Q
What are the non-gynae causes of acute pelvic pain?
A
Appendicitis IBS IBD Mesenteric adenitis Diverticulitis Strangulation of hernia UTI Renal/bladder calculi
3
Q
How should acute pelvic pain be investigated?
A
Urinary hCG (>24 = preg) MSU Triple swab - high vaginal, cervical, endocervical Bloods - FBC, G+S, CRP Pelvic USS Abdo x-ray (+/- contrast), CT, MRI Dx laparoscopy
4
Q
What are the important questions to ask when presented with acute pelvic pain?
A
LMP Contraception Unprotected sexual intercourse Ectopic preg RF (PID, endometriosis, pelvic/tubal surgery) PV discharge/bleeding Urinary/bowel symp
5
Q
What are the gynae causes of chronic pelvic pain?
A
Endometriosis
Adenomyosis
Adhesions
Pelvis venous congestion
6
Q
What are the non-gynae causes of chronic pelvic pain?
A
GI = IBS, constipation, hernia
Uro = cystitis, urethral syndrome, calculi
MSK = fibromyalgia
Neuro = N entrapment, neuropathic pain
7
Q
How should chronic pelvic pain been managed?
A
Analgesia = opiates, neuropathic tx (amitriptyline etc)
Hormonal = COCP, progestogen, GnRH analogues
Complementary
Surgery = hysterectomy
