Pelvic Pain Disorders and Cystitis

Pelvic Pain Disorders

Pelvic pain disorders can affect men and women of all ages. Pelvic pain may be the result of gynecologic, urologic, or colorectal causes and can often be difficult to diagnose. Our interdisciplinary team is dedicated to the management of this difficult, but treatable problem. For further information on chronic pelvic pain, visit the following link to “Chronic Pelvic Pain Syndrome and Prostatodynia,” a comprehensive article authored by Richard A. Watson, M.D., director of ambulatory urology in the Department of Urology.

Evaluation
The diagnosis of certain pelvic pain syndromes, such as interstitial cystitis or prostatodynia begins with a careful history and physical examination. Tests such as videourodynamics, cystoscopy, hydrodistension, and bladder biopsy may be indicated. Additionally, a full gynecologic or colorectal work-up may be in order, depending on the patient’s condition.

Treatments
The treatment of pelvic pain disorders is multifaceted and may require combination therapy to keep pain under control. With a multidisciplinary team including urologists, gynecologists, colorectal specialists, pain specialists, and holistic therapists, the Department of Urology offers each patient a comprehensive treatment plan to manage this complex problem. Treatment options may include:

  • Behavioral and dietary modifications: simple techniques to improve bladder function including pelvic floor muscle exercises, dietary modifications, alterations in fluid intake, and bladder retraining
  • Medical therapy: the use of certain medications designed to reduce overactivity of the bladder, which can aid in bladder control and decrease urgency of urination and urge incontinence
  • Pelvic floor biofeedback: physical therapy for the muscles of the pelvic floor. The goal of pelvic floor biofeedback is to gain greater control of the muscles. The technique can be used in the treatment of urinary incontinence, overactive bladder, urinary retention, pelvic floor disorders, and pelvic pain disorders.
  • Electrical stimulation: a gentle electrical current is delivered to the muscles of the pelvic floor resulting in temporary contraction of the pelvic floor muscles
  • Bladder instillations: medications that can be instilled directly into the bladder in an office setting to treat chronic pelvic pain and burning
  • Hydrodistension: a technique whereby large amounts of fluid are instilled in the bladder to stretch the bladder wall. The procedure, which is conducted while the patient is under anesthesia, can yield diagnostic and therapeutic results in patients with interstitial cystitis.
  • INTERSTIM® sacral neuromodulation: a novel technology whereby a gentle current is delivered to the nerve supplying the bladder and pelvic floor in order to treat overactive bladder, non-obstructive urinary retention, and pelvic pain disorders
  • BOTOX® therapy: a procedure in which an agent that paralyzes muscular activity is injected into the bladder to reduce bladder spasticity. BOTOX® therapy can be used to treat overactive bladder and urge incontinence.
  • Holistic therapy
 


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