If a combination of Physiotherapy and medication has been unable to relieve your pelvic pain, you may consider undergoing a pelvic surgery. Unfortunately pelvic surgeries, as with any surgery, have varying degrees of success. As a result they are often reserved for adults that suffer from chronic pelvic pain that has been unable to be treated through medication, and are finished having children. This is because it may not be possible to conceive following a pelvic surgery, and the benefits of any pelvic surgery are mostly lost in women following pregnancy and childbirth.

In this article we look at the types of most common pelvic surgeries, how to prepare for your pelvic surgery, how to improve your recovery, and potential complications. All procedures discussed may differ from the exact procedure you are offered, as your surgeon will design your procedure to specifically suit your needs.

The purpose of this article is to inform you of your options. You should always...

Any discomfort felt in the structures related to the pelvis, below the belly button, is considered as pelvic pain. It may be felt in the lower abdomen, perineum, anus, buttocks, or tailbone. In women it can also be felt in the vulva and vagina, and in men it can be felt in the penis and testes.

Pelvic pain can be categorised into:

• Acute pelvic pain - A pain that is sudden and unexpected, but there is often an obvious cause such as appendicitis, inflammation or infection.
• Chronic pelvic pain - A non-malignant pain related to the structures of the pelvis, that is persistent or recurrent over 6 months and is not associated with menstruation, pregnancy or sexual intercourse. Effected muscles, nerves and tissues may continue to send pain signals through the nerves of your spinal cord, to your brain, even after the original cause has been resolved. The pain itself is now the disease.
• Chronic...

Vulvodynia is chronic pain felt in the skin at the opening of the vagina, the vulva (including that felt in the labia, urethra and clitoris), that has been present for at least 3 months. There will be no identifiable cause of the pain as vulvodynia is not related to a skin condition or infection. The pain occurs as a result of the nerve endings in the skin becoming over sensitive. The pain is often present even when the area has no pressure on it.

Vulvodynia is a constellation of several, sometimes overlapping, diseases and processes - always with no identifiable cause. If the pain is only felt when pressure is applied, it is considered as vestibulodynia (previously known as vulva vestibulitis). The pain felt with vestibulodynia is only in a localised area where pressure has been applied; whether it be a touch, or friction when a tampon is inserted or during sex. At other times there is no discomfort.

Vulvodynia can affect otherwise healthy women of any...

Vaginismus is when the muscles of the pelvic floor, around the vagina, involuntarily contract when it is about to be penetrated. This prevents penetrative intercourse, gynaecological examinations, and the insertion of a tampon or menstrual cup. This is an involuntary reaction, often related to a fear of penetration rather than issues with muscle tone.

Vaginismus can be categorised by when it began to occur:

• Primary vaginismus is when you have never been able to have penetrative intercourse or, if you have, it has been extremely painful.
• Secondary vaginismus is when you have previously had comfortable penetrative intercourse, however that is no longer possible.

Vaginismus is not a common condition, reports suggest it affects only 0.5 - 1% of women globally. As with most intimate conditions, however, it is likely to be under reported as women do not always seek treatment for fear of embarrassment...

A urinary tract infection (UTI) is a very common cause of pelvic pain and discomfort. It is caused by bacteria entering the urethra, which can also travel up to reach the bladder and kidneys. This results in a number of symptoms, including; burning or pain when you urinate, you may need to urinate more often, and you may feel generally unwell.

Types of UTI

• Cystitis - When only the bladder is infected.
• Urethritis - When only the urethra is infected.
• Kidney infection - When one or both kidneys is infected, which can lead to serious kidney damage if left untreated.
• Lower UTI - When both the bladder and urethra are infected.
• Upper UTI - When the bladder, urethra and one or both of the kidneys are infected.

The urinary tract stores urine for long periods of time. When it is healthy it has a tight...

Pelvic inflammatory disease (PID) is a bacterial infection that affects the female upper genital tract; including the endometrium lining and tissue around the uterus (womb), ovaries and fallopian tubes. It can even reach the lining of the abdomen. Men cannot suffer from PID, but they can carry and transmit the bacteria to future sexual partners.

PID mainly affects sexually active women between the ages of 15-24 in the UK. In America, this equates to 4.4% of the sexually active female population.

If left untreated, PID can quickly result in pelvic tubo-ovarian abscesses in the ovaries and fallopian tubes. This can irreparably scar the tubes, making them too narrow for eggs to pass into the womb. This can lead to fertility issues, and makes you 6 times more likely to have an ectopic pregnancy (where the pregnancy is in the fallopian tubes rather than in the womb). Occasionally...

The pelvic floor muscles are responsible for your posture, the function of your bladder and bowel, and intimate sensations. Pelvic floor dyssynergia is a loss of coordination between these muscles and others in the pelvis. Often leading to issues in the way your bladder and bowel work, issues with the related muscles and bones in your hips and back, and pelvic pain as a result. Pelvic floor dyssynergia is an unintentionally acquired behavioural issue, often referred to as a functional issue rather than a structural (i.e. damaged muscle), neurological (i.e. disease of the brain) or pathological issue (i.e. disease).

The most common outcome of pelvic floor dyssynergia is issues with defecation. For an efficient bowel movement, there are a number of complex voluntary and involuntary movements that need to occur. The puborectalis sling muscle (involuntary) and the anal sphincter muscles (voluntary) need to relax. At the same time the abdominal muscles push down. This changes the ano-rectal...

Pelvic congestion syndrome (PCS), also known as pelvic venous congestion syndrome, is where the veins in the pelvis widen (dilate) allowing excessive blood to stay in the area. In women this is mostly concentrated around the ovaries, and in men it occurs in the scrotum and is called varicocele. The affected veins are classified as varicose veins, often with weak valves that allow blood to flow backwards and pool in the pelvis, instead of moving up and away to the heart. The extra blood often causes painful pressure that gets worse when the pelvis moves or is touched.

PCS is a common cause of chronic pelvic pain in women, reports suggest it affects more than 1/3 of women. Most of which have had multiple pregnancies and are aged between 20-45. Varicoceles occur in 15% of men, and only 2-10% of them will have any symptoms. Not all women suffer with the painful symptoms of PCS, and some may not even be aware they have the condition as they show no symptoms (asymptomatic)...

Pelvic abscesses are fluid filled masses of inflamed tissue that can occur within the female pelvis. The abscesses are caused by bacteria reaching the upper genital tract. The bacteria often originates from a separate genital tract infection, such as pelvic inflammatory disease (PID), or from otherwise healthy bacteria from the lower genital tract that has travelled up past the cervix.

Pelvic abscesses are exceptionally rare in men, and when they do occur they grow above the prostate. In women they are more common. The first area of the upper genital tract that is affected is the endometrial lining of the uterus. The infection can then spread through the fallopian tubes and to the ovaries, where they are called tubo-ovarian abscesses (TOA). The infection can also spread as far as the lining of the abdomen. Along this route the pelvic abscesses that form can cause a fever and a...