Pelvic Pain Unit in Seville. Personalized multidisciplinary treatment at Inebir

El chronic pelvic pain It is a type of persistent pain located in the pelvic region, between the hips and the navel, and that it remains during six months or moreIn many cases, it is a pain of unknown origin. neuropathicwhich means that it is related to the involvement of nerves in the pelvic area.

This type of pain includes disorders such as vulvodynia (vulvar pain), the coccydynia (pain in the coccyx), the pudendal nerve neuralgia and the pain associated with sciatic nerve, among others.

Pelvic pain can manifest in different ways depending on the patient:

• - Could be constant and slightEither intense and sharp, similar to a cramp.
• – It can appear in a intermittentdisappearing and reappearing over time, or being continuous.
• – It may be located at a specific point or feel in a generalized throughout the pelvic region.
• – In some cases, it is accompanied by a sensation of pelvic pressure or heaviness.

It is estimated that around 12% of women worldwide suffer chronic pelvic painThis makes it a common and often underdiagnosed health problem. The first step toward effective treatment is correctly identify the cause of the painThis is fundamental in order to apply the most appropriate therapeutic approach.

El chronic pelvic pain It can have multiple causes and, in cases, There is no single originbut rather a combination of several factors. Therefore, it is essential to carry out a specialized assessment to identify the main cause of the pain.

In general, the causes of pelvic pain can be classified into gynecological causes, urological, digestive, neurological, musculoskeletal y psychosocial.

Gynecological causes of pelvic pain

Cyclic gynecological causes

These are those related to the menstrual cycle:

• – Dysmenorrhea
  Pain associated with menstruation. It can be:
  • Primary, present since the first rules and without an apparent organic cause.
  • Middle School, when there is an underlying pelvic pathology.
• – Endometriosis
  Presence of endometrial tissue outside the uterus, most frequently in the ovaries, pouch of Douglas, peritoneum, and other pelvic structures.
• – Premenstrual syndrome
  Appearance of pelvic pain along with physical and emotional symptoms in the second phase of the menstrual cycle.

Non-cyclical gynecological causes

They are not directly related to menstruation:

• – Pelvic adhesions
  Internal scars that join tissues abnormally, usually after previous surgeries.
• – Endometriosis
  In addition to cyclical pain, it can cause persistent pain unrelated to the cycle.
• – Salpingoophoritis
  Acute or chronic inflammation of the fallopian tubes and ovaries.
• – Ovarian remnant syndrome
  Pelvic pain in patients undergoing hysterectomy in whom ovarian remnants have been preserved.
• – Pelvic congestion syndrome
  Presence of varicose veins at the ovarian or uterine level, responsible for chronic pelvic pain.
• – Ovarian and uterine neoplasms
  Both benign and malignant tumors can cause acute or chronic pelvic pain.
• – Pelvic inflammatory disease
  Chronic pain is usually due to recurrent infections or residual damage from previous episodes.

Gastrointestinal causes

The most frequent digestive cause of pelvic pain is irritable bowel syndrome, a functional disease characterized by alterations in bowel rhythm and abdominal or pelvic pain without a structural organic cause.

Genitourinary causes

Pelvic pain of urological origin is related to close anatomical connection between the bladder, urethra, and pelvic organs. Alterations in these structures can generate persistent pain that is easily confused with gynecological causes.

Neurological causes

El neuropathic pelvic pain It can appear due to entrapment or damage of the pelvic nerves, especially after surgical interventions.

Among the most frequent causes are:

• – Nerve damage following gynecological surgeries
• – Pudendal nerve involvement
• – Neurological damage secondary to deep endometriosis

This type of damage can cause conditions such as:

• – Vulvodynia
• – Coccygodynia
• – Pudendal nerve pain
• – Sciatica

Musculoskeletal causes

• – Pelvic muscle pain
  It may be due to alterations in the contraction and relaxation of the pelvic floor muscles.
• – Mechanical pelvic pain
  Pregnancy, trauma, or postural changes can alter the alignment of the pelvis and spine, causing persistent pain.

Psychosocial and neurological factors

Chronic pelvic pain can be influenced by physical, psychological and social factorsThese factors vary from patient to patient and can change over time. They do not invalidate the pain, but rather contribute to its complexity and must be addressed holistically.

At Inebir we address the diagnosis of chronic pelvic pain From a multidisciplinary approach, essential to correctly identify the origin of the pain and offer a truly personalized treatment.

Our medical team performs a individualized valuation, which begins with a detailed medical historyThis involves analyzing the patient's medical, gynecological, and surgical history, as well as the evolution of the pain. Following this, a complete physical examination, tailored to each patient.

When necessary, the diagnostic study is supplemented with specific tests that allow us to rule out or confirm the different causes of pelvic pain, both gynecological and neurological, musculoskeletal or urological.

Furthermore, throughout the entire diagnostic process, the patient can count on the support from our psychology unit, a fundamental pillar in the comprehensive approach to chronic pelvic pain and in improving quality of life.

Once you have made a accurate differential diagnosisThere are different options for the pelvic pain treatment, which are selected based on the origin of the pain, its intensity, its evolution over time and the characteristics of each patient.

The treatment of acute pelvic pain It is usually simpler and, in many cases, can be resolved through medical treatment, such as the use of antibiotics in infectious processes, or through surgical intervention when a specific pathology is suspected.

However, the treatment of chronic pelvic pain (CPP) It requires a more complex approach, demanding experience, specialization, and a multidisciplinary focus.

At Inebir we have a Highly specialized medical team in chronic and neuropathic pelvic pain, with extensive experience in laparoscopic surgery and minimally invasive surgical techniques, which allow safe and precise access to the pelvic anatomy.

After analyzing each case individually, our specialists establish the most appropriate treatment, which may include:

• – Pharmacological treatment, focused on pain management.
• – Hormonal treatments, when the origin of the pain so requires.
• – Surgical interventions, in those cases where they are indicated, with the aim of relieving pain and improving quality of life.
  

Our goal is to offer each patient the best possible therapeutic optionalways from a personalized, safe and evidence-based medical approach.