Summary about Disease
Frozen pelvis is not a specific disease but rather a clinical term describing a condition where pelvic organs (uterus, ovaries, fallopian tubes, bowel, bladder) are adhered to each other and the pelvic sidewalls. This adhesion creates a fixed, immobile mass within the pelvis, making it difficult to distinguish individual organs during a physical exam or imaging. It's typically a late stage manifestation of several underlying conditions.
Symptoms
Symptoms vary depending on the underlying cause and the extent of the adhesions. Common symptoms include:
Chronic pelvic pain
Dyspareunia (painful intercourse)
Dysmenorrhea (painful menstruation)
Dyschezia (painful bowel movements)
Dysuria (painful urination)
Infertility
Bowel obstruction (in severe cases)
Bloating
Fatigue
Causes
Frozen pelvis is generally a result of chronic inflammation and scarring within the pelvic cavity. Common causes include:
Endometriosis: This is the most common cause.
Pelvic Inflammatory Disease (PID): Untreated or chronic infection of the reproductive organs.
Previous Pelvic Surgery: Scar tissue formation after surgery.
Radiation Therapy: Can cause inflammation and scarring.
Advanced Pelvic Cancer: Growth and spread of cancer can lead to adhesions.
Diverticulitis (rarely)
Medicine Used
Medical management focuses on treating the underlying cause and managing symptoms. Specific medications may include:
Pain relievers: NSAIDs (e.g., ibuprofen, naproxen), opioids (for severe pain).
Hormonal therapies: For endometriosis, medications like birth control pills, GnRH agonists/antagonists (e.g., Lupron, Orilissa), and progestins.
Antibiotics: For Pelvic Inflammatory Disease (PID).
Laxatives/stool softeners: To manage bowel symptoms. Surgery is often required to release the adhesions and restore normal anatomy.
Is Communicable
No, frozen pelvis is not a communicable disease. It is not caused by an infectious agent that can be transmitted from person to person.
Precautions
Precautions are related to the underlying conditions that can lead to frozen pelvis:
Early diagnosis and treatment of Pelvic Inflammatory Disease (PID) through safe sexual practices and prompt medical attention for symptoms.
Managing endometriosis with appropriate medical or surgical treatment to prevent progression.
Careful surgical technique during pelvic procedures to minimize scar tissue formation.
Following recommended screening guidelines for pelvic cancers.
How long does an outbreak last?
Frozen pelvis is not an acute "outbreak" type of condition. It's a chronic state that develops over time as a result of the underlying inflammatory process. The symptoms may fluctuate in intensity, but the adhesions remain unless surgically addressed.
How is it diagnosed?
Diagnosis typically involves:
Medical History and Physical Exam: A thorough review of the patient's symptoms and past medical history, and a physical examination to assess pelvic tenderness and mobility.
Pelvic Exam: to assess the mobility of pelvic organs.
Imaging Studies:
Ultrasound: initial imaging test to visualise the organs.
MRI: Provides detailed images of the pelvic organs and can help identify adhesions.
CT Scan: Used less frequently than MRI, but can be helpful in certain cases.
Laparoscopy: Surgical visualization of the pelvic cavity is often the definitive method of diagnosis. It allows direct visualization of the adhesions and assessment of the extent of the disease. Biopsies can also be taken during laparoscopy.
Timeline of Symptoms
The timeline of symptoms varies widely depending on the underlying cause and the individual.
Early Stages: Mild pelvic pain, painful periods, or discomfort during intercourse. Symptoms may be intermittent.
Progression: As adhesions develop, symptoms become more constant and severe. Pain may become chronic, and bowel or bladder symptoms may appear.
Late Stages (Frozen Pelvis): Severe chronic pain, significant bowel and bladder dysfunction, infertility, and a fixed, immobile pelvic mass.
Important Considerations
Frozen pelvis is a complex condition that often requires a multidisciplinary approach involving gynecologists, surgeons, pain specialists, and other healthcare professionals.
Treatment is aimed at managing symptoms, addressing the underlying cause, and improving quality of life.
Surgery to release adhesions can be technically challenging and may not always be successful in relieving symptoms.
Recurrence of adhesions is possible, even after surgery.
Psychological support may be beneficial for patients dealing with chronic pain and infertility associated with frozen pelvis.