• The doctor would conduct a detailed query regarding the woman’s degree of pain, her personal overall health or family health history. Maintaining record of when symptoms occur could also be asked by the doctor.
• Gentle examination employing an ultrasound is done in case of women with complaints of pelvic pain. Mild pressing and minimal discomforting sensation is felt during the examination.
• Tender or sore points in the abdominal wall or deeper in the abdominal area are checked during the examination.
• During pelvic pain diagnosis, any indications of infections are checked and tests could be done for sexually transmitted diseases gonorrhoea, Chlamydia presence by taking cultures or samples from cervical or vaginal areas. Any tenderness is palpated for in the ovaries and uterus.
• Mostly implants due to endometriosis are present in the location at the back of the uterus in-between rectal and vaginal area which could solely be palpated by insertion of one of the inspecting fingers within the vagina and the other finger in the rectum. Pain assessment is incomplete until a recto-vaginal examination is conducted.
• It is vital for the doctor to ensure there is no pregnancy in a woman complaining of pelvic pain. In case of the slightest doubt of presence of pregnancy, relevant tests must be conducted.
• During vaginal probe ultrasound examination a fine, pliable probe is introduced within the vagina for capturing images of the interiors of the pelvic organs employing sound waves. This does not cause any pain and lasts for a couple of minutes. At times, the ultrasound exam could reveal presence of cyst, fibroid or other issues which might fail to be felt on examination.
• Laparoscopy procedure is a method performed for examination of ovaries and tubes and could be requisite for ascertaining a finding. Laparoscopy is of two kinds namely diagnostic and operative. During diagnostic laparoscopy, the gynaecologist would be looking at the pelvis. However, several veteran gynaecologists are ready to do an operative laparoscopy during the analogous time they are doing diagnostic laparoscopy. In operative laparoscopy, when an issue is encountered, treatment in the form of laser and optionally other apparatus are employed. Instances of operative laparoscopy comprise of adhesion freeing, removal of either ovarian cyst formations or endometriosis.
• In case of an issue within the uterus like submucous fibroids is doubted then hysteroscopy is performed for looking straight within the uterus. It is generally an uncomplicated office method that could additionally reveal presence of adenomyosis that is causal for excruciating menstrual pains or month-long lasting pains.
• In case strong bladder signs are present in spite of urine cultures not revealing any indications of infection, then interstitial cystitis could be doubted for which cystoscopy (checking within the bladder) – a simple method is done under influence of general anaesthesia for checking interstitial cystitis presence. Sometimes, the doctor would perform cystoscopy during the analogous instant as laparoscopy in case interstitial cystitis is doubted.
• In case pain is doubted to arise from stomach or intestines then the woman could be referred to an expert in that field for an exam generally done before a laparoscopy procedure, although endometriosis could also be causal in case of intestinal issues.

The persistent pelvic pain is a major ailment for many women. Certain reasons behind severe pelvic pain can be analysed and cured such as:

• Pelvic pain originating due to abnormal uterine tissue growth known as Endometriosis.
• The normally known pelvic inflammatory disease that causes pelvic pain.
• Tissue adhesions due to their clumping together following inadequate healing from surgical intervention, infection or certain disease.

Nearly one in about seven women endure extreme pelvic pain, however majority of the cases cannot be directly linked to the above said conditions or be healed by the associated treatments. The pain mostly occurs at the time of monthly menstrual cycle (dysmenorrhea), pain in between menstrual cycles listed as non-cyclic pain and pain experienced at the time of sexual contact known as dyspareunia.

As the reason behind the pain or its treatment is still not clear, the doctors have attempted to resolve the pain itself using surgical destruction of the pelvic nerves. Earlier this procedure was carried out by open surgery; however, now-a-days doctors employ the minimally invasive LUNA procedure.

There have always been riddling controversies regarding its workability. But, there has been a wide-ranging study that was conducted on close to five hundred women ailing from pelvic pain that persisted for greater than 6 months at eighteen hospitals based in U.K.

The usual procedure employed on women with pelvic pain is to undergo laparoscopic exam wherein a fine tube is introduced within the pelvic section. The women that participated in the study consented to go through LUNA or not go for it, depending on whether the exam detected an untreatable reason for their pain, although those women facing minimum endometriosis also were integrated into the study. The scientists assessed the pain of those women for time span ranging from 3 months to 5 years afterwards.

The base line depicts that LUNA failed to assuage any kind of pain or even enhance life quality in any significant manner. The report submitted by Jane Daniels and her associates at the Birmingham Women’s Hospital observed that after three months subsequent to undergoing the LUNA procedure, the women stated that they experienced lesser pain irrespective of  undergoing the LUNA procedure or not. The conclusion drawn was that the initial pain decline might have been due to the effect of placebo and could be attributed to the assurance furnished by the laparoscopic exam that revealed absence of grave pathology.

Regrettably, in spite of these discoveries sparing several women the unwanted LUNA procedure, there still remains no adept treatment for this real medical ailment that can take its toll over lives and precious relationships.