Examination and Investigation

Abstract

In general surgical practice about 60 % of patients with chronic pelvic pain will be direct referrals, 30 % will have been referred by gynaecologists and fewer than 10 % will have been seen by an orthopaedic surgeon. Nearly all the patients with acute and chronic perineal disorders will have been referred directly to the general surgical clinic. The surgeon will need to ascertain, by detailed history taking and physical examination, the most probable source of the patient’s pain and to allocate the symptoms and signs to one compartment of the pelvic cavity. The patient will be referred to an orthopaedic surgeon or gynaecologist as appropriate. If the patient has been referred from a gynaecologist she will have had a pelvic examination and probably a pelvic ultrasound or computed tomographic scan. Patients referred from the orthopaedic department will have had a straight X-ray of the abdomen and pelvis.