Related Conditions
With endometriosis, patients may also be experiencing other pelvic floor symptoms and conditions that are the result of endometriosis such as chronic pelvic pain, or they may have conditions that are not a result of the disease.
Experiencing persistent pelvic pain, bladder/bowel symptoms, or pain with intercourse after endometriosis excision surgery is common and does not mean your surgery did not go well and you need to run back to the OR. Endometriosis has been present in your body for many months to years prior to your endometriosis surgery. The presence of Endometriosis pre-operatively has affected the way your pelvic nerves fire and has caused your pelvic floor muscles to go into a chronic guarding state. Once Endometriosis is excised, the nerves and muscles of the pelvis quite often then require their own treatment to reverse the neurogenic inflammation and the chronic pelvic floor muscle spasms.
In general, for the first couple of days after endometriosis surgery, you may experience bloating and discomfort from the gas that was used to distend your abdominal cavity for the laparoscopy. You will also have some cramping and post-operative soreness/tenderness.
At PRM, we commonly see patients with pelvic pain following their surgery because endometriosis is a systemic inflammatory disease process that promotes inflammation in the pelvis and irritates the nerves, causing your muscles to go into a chronic spastic guarding state. Even when the endometriosis is properly removed surgically, the nerve irritation and inflammation, along with a spastic pelvic floor remain.
With endometriosis, patients may also be experiencing other pelvic floor symptoms and conditions that are the result of endometriosis such as chronic pelvic pain, or they may have conditions that are not a result of the disease.
Although some pain after endometriosis excision surgery is normal, pelvic pain and pelvic floor dysfunction may persist because of nerve inflammation, so it is important to treat these symptoms postoperatively.
Persistent pelvic pain
Heavy menstruation
Pain during intercourse
Infertility
Pain with bowel movement
Once a proper diagnosis has been given, we offer a proprietary office-based procedure to treat pelvic pain and dysfunction following endometriosis excision surgery. This treatment consists of a series of pelvic nerve and muscle treatments to directly target the spastic pelvic floor muscles, inflammation in the pelvis, and nerve pain. Depending on the underlying cause of your pain, other modalities may be needed in addition to our treatment. Since pelvic pain can be multifactorial, the most effective treatment option is a multimodal approach that targets many different contributing factors.
Experiencing pelvic pain and dysfunction following endometriosis surgery can be difficult, but our team of pelvic pain specialists will listen to you, validate your experiences and symptoms, and partner with you on your rehabilitation journey.
Your pain should be improving by the third day after surgery. It is very important that you call us after surgery if you don’t feel better each day compared to the previous day.
After two weeks, you should feel almost back to normal, but full recovery typically takes up to four weeks.
After two weeks, you will have a follow-up office visit to ensure all is well and to check your abdominal incisions, which by this time should be almost completely healed. Your surgeon will discuss with you the surgical findings and the follow-up treatment plans, including post-habilitation using The PRM Protocol.
First, our providers will ask questions about your medical history and listen to your symptoms to get a full picture of what is going on with you.
Next, an external exam of your hips, abdomen, and posterior sacrum.
Next, your pelvic nerves are evaluated externally with a soft cotton tip.
Next, with your consent, gel is placed on a gloved finger and an internal exam is performed to allow us to evaluate the nerves and muscles within the pelvis.
There is no speculum required as we are evaluating the pelvic floor muscles and nerves, not the organs.
Sometimes patients will need Imaging to help us understand if there is an associated cause of the pelvic nerve and muscle pain and dysfunction found on the exam.
Oftentimes, treatment can be started the same day as there is no downtime. Our patients have been suffering with pelvic pain symptoms for 6+ months. We like to get them on the road to feeling better as soon as we can as the longer the symptoms are present the harder it is for us to resolve them.
Our pelvic pain specialists are experts in recognizing the symptoms of and diagnosing pelvic pain conditions. With The PRM Protocol, we go further than addressing the symptoms on the surface – we treat the underlying causes of pelvic pain.
