Chronic pelvic pain
Pain that has lasted this long deserves a careful evaluation.
Six months. Two years. A decade. If the pain has outlasted the diagnoses, we start over — history, examination and imaging read together, not in isolation. Pelvic pain often has more than one contributor, and the plan follows what the evaluation shows.
The evaluation
How the first visit works
Your history, in full
Pain pattern across the cycle, bowel and bladder symptoms, prior surgeries and what each one found, treatments tried, and the effect on your work, sleep and relationships.
A focused examination
Depending on your symptoms, this may include the pelvic-floor muscles and the nerves of the pelvic wall.
Imaging read with you
Ultrasound or MRI ordered when it will change the plan, and reviewed together on screen.
Treatment options
Surgery is one tool, not the only one
Hormonal suppression for endometriosis and adenomyosis. Pelvic-floor physical therapy by referral. Evaluation of a bladder or bowel component with the appropriate specialist. Nerve-directed therapy when a nerve is the likely source.
When examination points to endometriosis, adhesions or a cyst that can be treated surgically, robot-assisted laparoscopy is one of the options discussed — as a plan with a defined goal, not an exploratory look. CONFIRM: which non-surgical treatments Dr. Weiss offers in-office vs refers out.
FAQ
Pelvic pain questions
What counts as chronic pelvic pain?
Pain below the navel lasting six months or more, severe enough to affect daily life or need treatment. It is a symptom, not a diagnosis — the job is to find what is driving it.
What causes are you looking for?
Endometriosis, adenomyosis, adhesions from prior surgery or infection, ovarian cysts, fibroids, pelvic-floor muscle spasm, nerve entrapment such as pudendal neuralgia, bladder pain syndrome and bowel causes. Often more than one is present.
Will I need surgery?
Not necessarily. Many patients improve with targeted medication, pelvic-floor physical therapy or treatment of a bladder or bowel component. Laparoscopy is offered when the history and exam point to disease that can be removed.
My imaging was normal. Does that mean nothing is wrong?
No. Superficial endometriosis and adhesions are often invisible on ultrasound and MRI. A careful examination and history matter as much as the pictures.