Journal List > Korean J Obstet Gynecol > v.54(9) > 1088336

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Ha, Son, Kim, Jung, Chun, Kim, Kim, and Cho: Chronic pelvic pain after hysterectomy in a patient with depressive disorder: A case report
Case Report
Korean Journal of Obstetrics & Gynecology

Korean Journal of Obstetrics & Gynecology 2011; 54(9): 557-560.

Published online: 26 September 2011

DOI: https://doi.org/10.5468/KJOG.2011.54.9.557

Chronic pelvic pain after hysterectomy in a patient with depressive disorder: A case report

Jae-Eun Ha, MD, Hyun-Joo Son, MD, Bo-Young Kim, MD, Yun-Ji Jung, MD, Gun-Young Chun, MD, Jang-Heub Kim, MD, Mee-Ran Kim, MD, Hyun-Hee Cho, MD

Department of Obstetrics and Gynecology, The Catholic University of Korea School of Medicine, Seoul, Korea.

Corresponding author: Hyun-Hee Cho, MD. Department of Obstetrics and Gynecology, The Catholic University of Korea School of Medicine, #505 Banpo-dong Seocho-gu, Seoul 137-701, Korea. Tel: +82-2-2258-6174, Fax: +82-2-595-1549, drrabbit@catholic.ac.kr

Received 16 May 2011       Revised 11 July 2011       Accepted 26 July 2011

Copyright © 2011. Korean Society of Obstetrics and Gynecology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Chronic pelvic pain, defined as a non-cyclic pain of at least 6 months duration, is severe enough to require medical care or to cause disability. For such reason, only physical approaches and managements of chronic pelvic pain sometimes fail. Depression and posttraumatic stress disorder (PTSD) can cause chronic pelvic pain and affects the course of pain management. This case is about chronic pelvic pain of 39-years-old unmarried woman with adenomyosis. She wanted to control her pelvic pain with medical treatments of adenomyosis, but finally decided to scarify uterus due to uncontrolled pain. Pshychosomatic symptoms were considered to cause the pain because her pain did not disappear even after hysterectomy. She was diagnosed with PTSD and depression. This case suggests that chronic pelvic pain patients always need psychological evaluation even if they have definite causes of pelvic pain in gynecological area.

Keywords: Pelvic pain, Depression, Stress disorders, post-traumatic, Psychosomatic symptom

Figures and Tables

Fig. 1
Magnetic resonance imaging findings of the pelvic organ. Diffuse enlarged uterus showed highly heterogeneous signal intensity on T2WI. High signal intensity of endometrial cavity showed obliterated junctional zone. Uterus showed high signal intensity on T1WI. In contrast imaging, lace like enhancement of endometrial cavity and heterogenous enhancement of uterine wall was noted. R/O uterine sarcoma such as endometrial stromal sarcoma. R/O, rule out.
kjog-54-557-g001

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