Multidisciplinary Approach to Pelvic Pain

Guest: Isabel C. Green, M.D.

Host: Darryl S. Chutka, M.D. (@ChutkaMD)

Pelvic pain can be challenging. It can have a variety of presenting symptoms since it can originate from a variety of organ systems. When pelvic pain becomes chronic, it becomes even more challenging. It’s associated with significant direct medical costs as well as indirect costs as it frequently results in work absenteeism. Patients with chronic pelvic pain are often initially evaluated by primary care providers, but referral to specialists is quite common. Due to the variety of symptoms associated with chronic pelvic pain, multiple specialties often are asked to evaluate these patients. This frequently results in patients being passed back and forth between various medical specialties. It therefore becomes important for primary care providers to become comfortable evaluating and managing patients with pelvic pain. Our guest for this podcast is Dr. Isabel Green, a physician from the Department of Obstetrics and Gynecology at the Mayo Clinic. We’ll discuss how to effectively evaluate patients with pelvic pain, “red flag symptoms” to watch for, useful laboratory tests to order, and common imaging studies which can be helpful in establishing a cause for the pain. We’ll also discuss the benefits of a multi-disciplinary approach to pelvic pain.

Specific topics:

• Categorization of pelvic pain
• Appropriate evaluation of pelvic pain including the clinical history, physical exam, laboratory tests and imaging studies
• Relationship of chronic pelvic pain with other symptoms such as anxiety, depression, insomnia, and work/relationship issues
• Chronic pelvic pain representing a form of centralized pain
• Advantages of a multi-disciplinary approach to evaluating and managing chronic pelvic pain

Additional resources:

• Chronic pelvic pain: ACOG practice bulletin, number 218. Obstet Gynecol. 2020 Mar; 135(3):e98-e109. doi: 1097/AOG.0000000000003716.

Connect with the Mayo Clinic’s School of Continuous Professional Development online at https://ce.mayo.edu/ or on Twitter @MayoMedEd.