For patients with bleeding, measuring Hb or Hct identifies anemia. Measuring ESR or C-reactive protein may help identify an inflammatory or infectious process. Laparoscopy can confirm the diagnosis and provide histologic documentation. It can also confirm that there is no anatomic abnormality of the pelvic or abdominal organs. Treatment Treatment should be directed at the specific cause of the pain, if possible.
Hypnosis helps relieve pelvic pain due to functional causes unamenable to surgery.
Uterosacral nerve ablation is reserved for patients with central pelvic pain or dysmenorrhea unresponsive to medical therapy. Long-term complications are unknown. Presacral neurectomy is reserved for patients with central pelvic pain, dysmenorrhea, deep-thrust dyspareunia, or sacral backache unresponsive to conservative therapy. Hysterectomy is reserved for patients with chronic pelvic pain unresponsive to medical or conservative surgical therapy. Patients without known organic pelvic disease must be informed that their pain may remain or even worsen after hysterectomy.