Chronic Pelvic pain

[annabella]

For the last 4 years I have had recurrent episodes of pelvic/abdominal pain which were treated with general antibiotics due to inflammation, however no cause was found and further investigations were not arranged because once I had completed the antibiotics the pain and symptoms resolved.
However about 8 or 9 months ago the pain re-occurred, I was initially diagnosed with a urine infection, then after antibiotic treatment 3 or 4 different types, I was started on treatment for pelvic inflammatory disease. Each course of antibiotics would improve my symptoms then about 3 or 4 days after I finished them my symptoms would come back. The pain got so severe I could not eat or drink and I collapsed and I was taken to hospital where a scan revealed a 10cm tubo ovarian abscess. I had laproscopic surgery to drain the abscess 4 months ago, but it has not resolved completely and is now growing in size again. I have had 3 more hospital admissions and treated each time with antibiotics by a drip then 14 days of tablets which improves the symptoms, then they return. My notes say anatomical distortion of normal abdominal structures due to adhesions and to have open surgery and at best to take out an ovary and tube. I am beginning to become really miserable and I face loosing my job because I cant walk far due to the pain.

I think what I am trying to ask.
Are there any lifestyle changes I can make in order to reduce the pain?
After all these infections and removal of a tube will my chances of having a baby will be reduced? I don't have children at the minute. I have never had a sexually transmitted infection so where else does PID come from? I have epilepsy related to periods so would removing an ovary make my seizures worse?
If the adhesions are removed in surgery do they come back?

[Infertility Network UK]

Hi annabella. Oh my goodness! You certainly have been through so much suffering. Remember, that you are the most important person here, and you need to get better. Perhaps the time has come to have the treatment recommended and to have the ovary and tube removed. All sounds drastic, but looking on the brighter side, your pain would be gone and you can continue working. Obviously, losing an ovary and tube may make it a little harder to conceive, but when you come to try and there is a problem, then there are treatment options to help you. PID is a wretched disease, and sometimes a reason for it happening is never found. In your case, it may have been caused from the cyst developing, I don’t know. I would imagine too, that once you have the operation, maybe your periods would settle and your epilepsy be better controlled – who knows? Lots to think about Annabella, but regarding lifestyle changes, just make sure you are a healthy weight, eat well, don’t smoke and don’t drink alcohol. Some gentle exercising may help too, or even just floating around in a swimming pool, if you are not able to swim. I really do wish you well with whatever is decided, and hope that you can soon look forward to a pain free life again. Diane

[annabella]

Thank you
Do you know why if the abscess is in the tube, they would need to take my ovary? I am very confused

[Mr Peter Greenhouse]

A tubo-ovarian abscess (TOA) is nowadays very rare and is the most severe form of chronic PID / pelvic infection usually resulting from either poorly treated or repeated re-infection - it's critically important that your partner should have been tested & treated to make sure that they don't have an infection such as chlamydia which they might pass back to you.
The reason that the ovary will need to be removed is that the TOA involves the end of the tube enveloping and fusing with the ovary, so you can't tell where the tube stops and the ovary starts - i.e. they have become one and the same inseparable structure. That's why they need to be removed together to prevent refilling of the abscess. This will remove the source of the infection and should improve your pain.
Good luck with the procedure.

[annabella]

Thank you for your reply, makes sense now as to why they take both, not a great deal gets explained when I go and see the consultant.