There are many possible reasons for one to experience ongoing pain in the bladder and genital area. The causes of pain and the perception of pain severity vary tremendously from person to person. Because there are so many structures that pass through the pelvis, it is often difficult to determine the underlying source or multiple sources of the pain. Because both urologic and gynecologic sources may be involved it is very important to see the “whole picture” and not approach this only through the eyes of a gynecologist or urologist, therefore a Urogynecologist, like Dr. Thompson is most capable of developing a treatment plan for your chronic pelvic pain.
Common Pelvic Pain Categories
INTERSTITIAL CYSTITIS (IC) – also known as the painful bladder syndrome. It affects women of all ages. In general it feels like a bladder infection (UTI) that never seems to go away. It is often misdiagnosed as a recurrent UTI. Patients often experience pain in the mid lower pelvis and or in the vaginal area. Please see the Interstitial Cystitis page on our website for more information.
VULVODYNIA – This condition results in persistent pain anywhere in the vulva. The pain is often exacerbated by any contact to the vaginal area such as wearing tight clothing or even just sitting on a hard seat. It often times makes sexual intercourse very painful or impossible. Symptoms such as itching, stinging, soreness, redness or irritation can be sporadic or constant. The discomfort can be centralized in one area such as the vaginal opening, or spread throughout the entire vulvar zone.
There is a higher likelihood of Vulvodynia if a woman has any of the following chronic pain-related conditions:
o Interstitial cystitis
o Irritable bowel syndrome
o Chronic fatigue syndrome
LEVATOR SYNDROME (pelvic floor dysfunction) – This condition is thought to be caused by spasms in the pelvic floor muscles. These muscle spasms result in ongoing vaginal pain that is often felt deep in the vagina or at the bladder. Often times, pelvic floor muscle spasms will feel like a urinary tract infection. Stress, sexual intercourse, a full bladder, constipation or any of the many pelvic pain syndromes often exacerbates it. In addition to pain, the tightening of the pelvic floor muscles may make it difficult to pass urine and stool.
ENDOMETRIOSIS – This condition affects an estimated 10% of women during their reproductive years. Many remain undiagnosed and are therefore not treated. Endometriosis often results in either constant pain, or more commonly, pain that fluctuates with the menstrual cycle. It is believed to be caused by abnormal deposits of cells similar to endometrium (the hormone sensitive lining of the uterus) throughout the pelvis. The endometrial tissue may even deposit in the bladder and cause you to have blood in your urine at the time of your period.
Please watch this video to learn more about Endrometriosis.
URETHRITIS / URETHRAL SYNDROME – Pain that originates from the urethra; often results in burning during urination and/or sexual intercourse. Again, the symptoms may be similar to those of a urinary tract infection, however the urine culture is negative.
Helpful link on Urethritis/Urethral Syndrome.
URETHRAL DIVERTICULUM – The urethra is the tube that carries urine from the bladder out of your body. A diverticulum is an out pouching or a pocket that forms in the urethra. It may present as a firm mass protruding from the vagina. It is associated with causing pain during sexual intercourse, recurrent urinary tract infections, and dribbling urine when you stand after urinating (post void dribbling). Urethral Diverticulum may be treated surgically, when symptomatic. However, in many cases they are found during a gynecological exam and may be left untreated if the patient has no pain or other related symptoms.