Since chronic pelvic pain has so many causes, a hysterectomy may or may not relieve the discomfort. Determining the exact origin of the pain is essential to making a decision about whether or to not to have a hysterectomy or some other form of treatment.
What is Hysterectomy?
A total hysterectomy is a surgical procedure in which the uterus and cervix are removed. Sometimes, a partial hysterectomy is performed removing only the uterus and leaving the cervix attached. If a patient has cancer, a radical hysterectomy that also removes part of the vagina and surrounding tissues is performed. The ovaries and fallopian tubes are sometimes removed during a hysterectomy, especially if there is a family history of ovarian cancer.
Gynecologic Causes of Pelvic Pain
About 20 percent of chronic pelvic pain stems from a variety of gynecologic causes, such as:
Endometriosis--a condition in which the uterine tissue, known as the endometrium, is present outside the uterus.
Adenomyosis--a condition in which the uterine lining also grows on the muscular walls of the uterus.
Chronic pelvic inflammatory disease--an infection usually caused by sexually transmitted organisms, although a previous ruptured appendix or scarring from earlier pelvic surgery may be the culprit.
Uterine fibroids--benign tumors common in women over 30. Uterine fibroids may cause heavy bleeding but don't usually cause pain unless they become enlarged.
Digestive and Urinary Causes
Sometimes, pelvic pain originates in the body's digestive or urinary systems. Irritable bowel syndrome causes chronic abdominal pain and constipation alternating with diarrhea. Diverticulitis occurs when a sac-like protrusion in the colon known as the diverticulum becomes inflamed and causes pain in the lower pelvis, as well as other digestive symptoms. Chronic inflammation of the bladder--known as interstitial cystitis--may cause pelvic pain and urinary urgency and frequency.
Other Causes of Pelvic Pain
Pelvic floor dysfunction may cause pain in the muscles that attach to the pelvic bones and the lower part of the spine. In addition to pain, pelvic floor dysfunction may cause constipation, pain with intercourse and frequent or urgent urination. Specially trained physical therapists can help alleviate the symptoms.
Will a Hysterectomy Help?
Careful diagnosis is necessary before determining whether or not to have a hysterectomy for chronic pelvic pain. If the pain is caused by large fibroids or uterine adenomyosis, hysterectomy is likely to help. In other instances, however, pain may still persist or be even worse following a hysterectomy--particularly for those with a history of pelvic floor dysfunction. Finding proper treatment for the underlying condition is the key to relief.
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