Memorial Hermann The Woodlands Hospital

Pelvic MRI in Women

An estimated one-third of all women will experience some form of pelvic pain in their lifetime. Although it is one of the most common causes of pain in women, it is also one of the most difficult to diagnose and manage. As many as three out of five women, who experience pelvic pain, never find out the cause of their pelvic pain.

Typically, women seek help from gynecologists, urologists or family practitioners who may not be able to pinpoint the cause. Adding to this difficulty is that many women are often embarrassed about pain in the pelvic area – below your bellybutton and between your hips – and wait until the pain is unbearable before seeking help.

Chronic pelvic pain is defined as any pelvic pain lasting more than six months. As many as one out of five women experience chronic pelvic pain. This differs from acute pain, which may indicate a specific injury. In chronic pelvic pain, the initial injury or problem may have disappeared but the pain continues because of changes in the nervous system, tissues, or muscles.

Among the signs and symptoms of chronic pelvic pain include:

• Severe and steady pain
• Pain that comes and goes (intermittent)
• Dull aching
• Sharp pains or cramping
• Pressure or heaviness deep within your pelvis
• Limited physical activity

Accurate Diagnosis and Treatment
Although there are many tests that can be performed to determine the cause of your pain, including pelvic exam, cultures, pelvic ultrasound or laparoscopy, a Magnetic Resonance Imaging (MRI) of the female pelvis is one of the most accurate methods of pinpointing what is causing your discomfort.

For many women, this non-invasive test is more comfortable than many of the alternatives and can clearly show pelvic anatomy in 3 dimensions and accurately demonstrate pelvic abnormalities. Using this vital information, your doctor can uncover the exact source of the problem and quickly initiate the appropriate treatment regimen.

This elegant imaging technology is capable of diagnosing and staging malignant pelvic diseases, such as cervical cancer, endometrial cancer, vaginal cancer, vulvar cancer and ovarian cancer.

It can also diagnose benign causes of chronic pelvic pain, such as uterine leiomyomas (fibroids), adenomyosis, endometriosis and pelvic congestion syndrome, can also be diagnosed. MRI of the pelvis can clearly exhibits pelvic floor abnormalities, which can result in urinary incontinence and pelvic pain.

Common Cause of Pelvic Pain
Chronic pelvic pain, like most other chronic pain conditions, affects your physical and psychological well being. Some of the more common causes include:

• Endometriosis, a condition in which tissue from your uterine lining (endometrium) grows outside your uterus. These deposits of tissue respond to your menstrual cycle, just as your uterine lining does – thickening, breaking down and bleeding each month as your hormone levels rise and fall. Because it's happening outside your uterus, the blood and tissue can't exit your body through the vagina and become trapped in your abdomen. This can lead to painful cysts and adhesions.
• Adenomyosis, a condition in which tissue from your uterine lining (endometrium) grows inside your uterus and into the muscle, resulting in heavier menstrual bleeding.
• Tension in your pelvic floor muscles causes spasms of the pelvic floor muscles and can lead to recurring pelvic pain.
• Chronic pelvic inflammatory disease is the results of a long-term infection, often sexually transmitted, which causes your fallopian tubes to scar and adhere to your ovaries.
• Pelvic congestion syndrome caused by enlarged, varicose-type veins around the ovaries. These veins cause blood to pool in your ovaries and pelvic area.
• Ovarian remnant, which occurs after a complete hysterectomy when a small piece of ovary is left inside, which can later develop tiny, painful cysts.
• Fibroids, non-cancerous uterine growths, which may cause pressure or a feeling of heaviness in your lower abdomen.
• Irritable bowel syndrome – bloating, constipation or diarrhea – can be a source of uncomfortable pelvic pain and pressure.
• Interstitial cystitis, chronic inflammation of the bladder resulting in a more frequent need to urinate, characterizes interstitial cystitis.