Chronic Pelvic Pain May Not Yield to a Definitive Diagnosis

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Interventional Pain Specialist Dr. Douglas Spiel introduces a new option for treatment

Pelvic pain occurs in the lower part of the abdomen. It might be steady or intermittent, sharp or dull, mild or severe, and is considered chronic if it lasts six months or more. Often the patient cannot pinpoint the precise location of the pain. And while the pain might be a symptom of a specific disease or disorder, often it is a condition in its own right with no identifiable cause. “In those cases, the pain is likely to be caused by a malfunctioning nervous system,” says Dr. Douglas Spiel. “We have had remarkable success treating neurologically based pelvic pain with an innovative new device called the “Intellicath™ but first we must determine if there is an identifiable cause of the pain.”doug

Chronic pelvic pain may be caused by problems in the reproductive system, the urinary tract, or the lower gastrointestinal system. It may be the result of an infection, an injury, a previous surgery, or a wide range of medical disorders. Among the most common causes are:

  • Endometriosis, an often painful condition in which the tissue that normally lines the uterus starts growing outside the uterus, attaching to the ovaries and other organs. The tissue responds to monthly hormonal fluctuation just as the lining of the uterus does – thickening, breaking down and bleeding – but has no way to leave the body as with menstrual discharge. The result can be cysts, inflammation and the formation of scar tissue as well as fertility problems. Endometriosis affects 10% of girls and women in the United States during their reproductive years.
  • Interstitial cystitis, also known as painful bladder syndrome. It is characterized by chronic inflammation of the bladder, the need to urinate frequently, and pain or pressure when the bladder fills. Symptoms may be similar to those of a urinary tract infection but cultures reveal that no bacteria are present. Interstitial cystitis affects both men and women.
  • Vulvodynia, a condition of the external female genital organs. Pain or a burning sensation is sometimes triggered or made worse by touch or pressure, such as during sexual intercourse. The cause of vulvodynia is not known.
  • Pelvic floor dysfunction, which is characterized by painful tension or spasms of the muscles in the pelvic floor that support the pelvic organs. The causes of pelvic floor dysfunction aren’t known but traumatic injuries and vaginal childbirth may be contributing factors.

Other causes of chronic pelvic pain include irritable bowel syndrome, prostatitis, pelvic inflammatory disease, fibromyalgia, and more.

“For many sufferers of chronic pelvic pain, testing eliminates these disorders and the pain remains,” says Dr. Spiel. For others, even after treatment for these disorders, the pain remains. These are the people for whom misfiring nerve impulses are responsible and we can treat them successfully with the Intellicath™.”

The Intellicath™ is a catheter that is implanted in an out-patient procedure and over several days delivers a small amount of anesthetic to calm the nerves that are causing pain. “This process essentially resets the nervous system and delivers both immediate and long-lasting relief,” says Dr. Spiel.

For additional information, visit or call Dr. Spiel’s office at 732-548-2000.