chronic pelvic pain

I have had a chronic pain on the right side of my pelvis for over 15 years. It is a dull pain that gets worse with physical activity then the whole pelvic area gets tender. In 2000 fibroids were diagonised and removed. countless scans since then have discovered nothing. i have had 2 ceasarians. Last year i had a transvaginal scan which showed my ovaries were fine but they could not see the uterine lining. the pap smear and blood tests were all normal. what could this be?

[Elaine Brown, MD]

Hi!
It is possible that you have adenomyosis.  This is a form of endometriosis that occurs within the muscle tissue of the uterus.  It often forms in surgical scars such as scars from a C-section.  It could also be adhesions or scar tissue on the outside of your uterus connecting to nearby structures such as the pelvic wall.
The only way to diagnose and cure adenomyosis is with hysterectomy.
If you have lived with the pain for 15 years, major surgery is probably not necessary.
One other possibility is musculoskeletal pain, such as pain from the lower leg or hip muscles--that is unrelated to your "female" organs.
At any rate, if the pain has lasted that long, it is very unlikely to be a malignancy--which is the good news!
Good luck!
Dr B