Surgery

Overview

Sometimes chronic pelvic pain is caused by structural lesions. Depending upon the nature of the lesion, surgery may be necessary to diagnose and treat these problems.

Spinal Disease

Lumbosacral spinal degenerative disease (arthritis) can cause pain in the groin and pelvic regions. In some of these cases spinal surgery can alleviate this pain.

Tumors

Tumors in the pelvic region may cause chronic pelvic pain. Benign, slow-growing tumors may be present for many years before they are discovered. Surgery is generally necessary to establish a diagnosis, remove the lesion, and often relieve the pain.

Figure 1. MRI scan of the pelvis showing a large, well-encapsulated tumor (T) underneath the gluteal muscles, adjacent to the sciatic notch. This patient presented with chronic pelvic pain.

Figure 2. Intraoperative photo of that patient from Figure 1, showing the tumor (T) underneath the gluteal muscles (G) which have been divided and retracted, and compressing the sciatic nerve (S). Following a gross total resection, pathological analysis revealed a lipoma.

Hernias

Hernias can certainly cause pain in the pelvic and groin regions. These form from structural weakness in the abdominal wall, allowing the migration of intraabdominal contents to become trapped under the skin. A simple surgical procedure is generally necessary to repair these hernias.