Tests Procedures Diagnosing Pelvic Pain

Common Tests and Procedures Used When Diagnosing Pelvic Pain

Pain or cramps in stomach/pelvis area. Credit: MarsBars

Chronic pelvic pain is not something that affects women. In fact, men and women alike may be diagnosed with pelvic pain. Chronic pelvic pain is characterized by pain in the abdomen or pelvis that has lasted for longer than six months, is not easily controlled with over-the-counter pain medications and interferes with your quality of life. It can be caused by female disorders, such as endometriosis, or other disorders like irritable bowel syndrome (IBS).

The testing your doctor may perform to diagnose your problem depends on what he is looking to find out. Some tests are designed to pinpoint suspected pelvic pain diagnosis, while others are designed to rule out other potential causes of pelvic pain. The examination may also vary depending on whether you are a man or a woman.

Diagnosing Pelvic Pain with a Physical Exam

One of the first stages of diagnosing chronic pelvic pain is a physical exam. For women, this often includes a pelvic exam, much like you would expect from your gynecologist. Your doctor will check the muscles around the pelvis for signs of weakness, tension or damage. He will also check for any abnormal sensations, such as tingling or numbness, and tender points.

Diagnosing Pelvic Pain with Lab Tests

When diagnosing chronic pelvic pain, your doctor may run one or even a series of tests. Here are some of the most common lab tests for diagnosing chronic pelvic pain.

  • Pregnancy test: Women may be tested in the early stages of their pelvic pain to rule out an ectopic pregnancy, a pregnancy that occurs outside of the uterus.
  • Vaginal and cervical cultures: During the pelvic exam, the doctor may take samples of a woman’s tissues for analysis to rule out cancerous growth, bacterial infections or other potential tissue abnormalities.
  • Urinalysis: A urinalysis may be performed in men or women to rule out types of infections, such as urinary tract infection or those that cause some kinds of prostatitis.
  • Cystoscopy: This may be done, with or without biopsy, to rule out interstitial cystitis (IC). (See below)
  • Semen analysis: In men, the presence of white blood cells in the semen can be a sign of prostatitis. Semen analysis may be ordered to diagnose or rule out prostatitis.
  • Biopsy: Your doctor may order a biopsy of any of the structures in your pelvis, including the cervix, bladder, and colon, to rule out cancerous tumors as the cause of your pelvic pain.

Diagnosing Pelvic Pain with Scans

Some pelvic pain may be caused by abnormalities in the abdominal or pelvic cavities. Scans can help your doctor get a peek inside the cavities, which allows him to check for problems with the pelvic bones themselves or the tissues that connect them. Scans for diagnosing pelvic pain can include one or more of the following:

  • Ultrasound

Diagnosing Pelvic Pain Through Surgery

Sometimes a scan is not enough for your doctor to get a clear picture of what is going on in your abdominal and/or pelvic cavity. In some cases, he might order exploratory surgery for a closer look at what might be causing your pelvic pain.

During exploratory surgery, a tiny camera is inserted through a small incision. Your doctor may perform a laparoscopy by inserting the camera through your belly button. Alternatively, depending on what he is looking for or trying to rule out, he may insert the camera into the bladder (cystoscopy) or into the colon (sigmoidoscopy).

Diagnosing Pelvic Pain with Nerve Conduction Testing

Because some pelvic pain conditions are caused by pelvic nerve damage or dysfunction, your doctor may order nerve conduction testing. These tests measure the rate and speed at which the nerves in the pelvis and groin carry impulses. Discrepancies in these impulses can indicate nervous problems as the cause of your pelvic pain. If the impulses are normal, nerve dysfunction can be ruled out as the cause of pelvic pain.

Diagnosing Pelvic Pain with Bladder Testing

In addition to urine analysis or a cystoscopy, your doctor may want to see how well your bladder is performing. In addition to questions about urinary frequency and incontinence, your doctor may perform tests to see how your bladder fills and empties. He may also check the performance of your bladder sphincters, which are the muscles that release during urination and contract to hold the contents of the bladder in place. Bladder testing can help diagnose prostate problems or other bladder dysfunctions as a cause of pelvic pain.

Diagnosing Pelvic Pain with Bowel Testing

In addition to a sigmoidoscopy, your doctor may perform tests to see how well the sphincters of your anus are working. These sphincters relax during a bowel movement, but should remain contracted otherwise to keep the contents of the bowels in place. Bowel testing may also be useful when ruling out conditions such as IBS.

How Long Will it Take to Diagnose My Pelvic Pain?

It’s hard to say. Some pelvic pain causes can be determined immediately, as is sometimes the case with conditions caused by infection or pelvic tissue damage. Other causes of pelvic pain, such as nerve disorders, may take longer to pinpoint. Some people may go for many months or even years before you are accurately diagnosed.

To help your doctor during the diagnosis stage, document your pain using a pain journal. Be sure to include which activities increase your pelvic pain, and which provide relief. It is often useful to track your bowel and bladder function as it relates to your pain, as well as documenting your menstrual cycle.


National Guideline Clearinghouse. Chronic Pelvic Pain.  http://www.guideline.gov/summary/summary.aspx?doc_id=12530

National Pain Foundation. Pelvic Pain: Diagnosis. http://www.nationalpainfoundation.org/articles/272/diagnosis

The Merck Manuals Online Medical Library. Pelvic Pain. http://www.merck.com/mmpe/sec18/ch242/ch242d.html

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