For many women, pelvic pain can be persistent, extremely uncomfortable, and in some cases, debilitating, and it may become worse without appropriate medical care. GPs, gynaecologists, and other health professionals play a key role in referring, diagnosing and providing the necessary treatment for patients presenting with pelvic pain, as symptoms of this type can suggest a serious underlying condition. While most gynaecologists and women’s health specialists are extremely diligent and professional, the quality of care provided by some may fall below the standard expected. In this article, we will discuss the important role that expert gynaecology witnesses can play in achieving a successful outcome in cases related to clinical negligence, including where the cause of pelvic pain has not been diagnosed or has been incorrectly diagnosed.
What is chronic pelvic pain?
Chronic pelvic pain is typically characterised by discomfort below the belly button and between the hips that has been ongoing for six or more months. According to the NHS, symptoms of pelvic pain can include:
- a sharp, stabbing or burning pain
- a pain that comes on slowly but does not go away
- a dull or heavy ache, or feeling of pressure
- a twisted or knotted feeling
- a cramping or throbbing pain, which may come and go
- pain during exercise, having sex, or while urinating
Unfortunately, where the cause of pelvic pain is not identified and treated in a timely manner, the implications may be significant and debilitating. For example:
If not diagnosed, endometriosis may require extensive surgery and can lead to infertility. For this reason, based on the NICE guidelines, a patient presenting with severe, persistent or recurrent symptoms of endometriosis, pelvic signs of endometriosis, or where initial management is not effective should be referred to a gynaecologist.
Ovarian cysts, a common cause of chronic pelvic pain, can cause significant discomfort, bloating and irregular periods.
Other conditions such as ectopic pregnancy and cancer, if not spotted quickly, can be life-threatening. Where a patient is suspected of having cancer, they are supposed to:
- Be urgently referred and seen by a specialist within two weeks
- Diagnosed no more than 28 days after referral
- Start receiving treatment within 62 days of receipt of the referral or 31 days from the date when they agreed on a treatment plan with their doctor
Once a patient is referred with a suspected ovarian, uterine, or another type of cancer, gynaecologists, are supposed to carry out and review the results of a prescribed set of tests, including a physical examination, CT scans, ultrasound, and blood tests for signs of tumour markers, to arrive at a diagnosis and then recommend the most suitable treatment. Any delays in referral, diagnosis or treatment can lead to poorer clinical outcomes.