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Pelvic Pain Due to Placement of the Vaginal Cuff after Hysterectomy: Case Report and Osteopathic Manipulative Approach to Treatment

Journal: The AAO Journal Date: 2006/12, 16(4):Pages: 11-16, type of study: case report

Free full text   (https://www.academyofosteopathy.org/aaoj)

Keywords:

case report [514]
hysterectomy [3]
OMT [2951]
osteopathic manipulative treatment [2973]
women [333]
female [379]
pelvic anatomy [1]
pelvic pain [58]

Abstract:

Hysterectomy is performed on more than 570,000 women a year in the United States with an estimated 21.2% of U.S. women having undergone the procedure. The most frequent indications are leiomyomas, abnormal bleeding and chronic pelvic pain. While hysterectomy may provide for the relief of chronic pelvic pain, it may also be a cause. Common attachment sites of the vaginal cuff after hysterectomy may include the cardinal, uterosacral or sacrospinous ligaments. Proximity to levator ani and obturator internus makes injury to these muscles a risk for causing pelvic pain. A case presentation of pelvic pain secondary to obturator internus injury during attachment of the vaginal cuff will be described with a review of the anatomy of the area. After initial osteopathic evaluation and treatment, one patient had the vaginal cuff repositioned by the surgeon with significant improvement in pain. Followup osteopathic manipulative treatment alleviated most of the persistent pain symptoms.


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