Pelvic pain is a condition that does not yet have the resources or attention that it warrants and is an area that has been taken up as an area of interest and expertise development by AAGL and the FMIGS programs. Structured programs that incorporate pelvic pain clinical education and didactic education are crucial in addressing this blind spot in residency training. While pelvic pain is a complex process that is part of many medical specialties, there is a component that is housed within the specialty of obstetrics and gynecology. Obstetrics and Gynecology specialists, as well as minimally invasive gynecologic surgery specialists, offer unique treatment options for complex pelvic pain, along with other clinical treatment options from larger systemic chronic pain conditions.
Clinical education in pelvic pain is a unique and challenging environment, with lack of infrastructure support and limitation of resources. The invisible drivers or forces such as payer regulations, or the lack of resources for chronic and debilitating pelvic pain, have left a gap and need for clinical development. Chronic pelvic pain conditions have been traditionally disregarded because of the lack of focus, funding, and inclusion in research priorities. This has left the medical community with sometimes limited clinical treatment options, however, through many clinical care specialty programs, this access to care is still facilitated. As May is pelvic pain awareness month, it is an opportunity for MIGS Fellowship programs to identify clinical education needs at their home institutions to try to improve care delivery for patients that we serve with pelvic pain. It is also an opportunity to pave the way for structured clinical education programs that serve patients with pelvic pain in the capacity that our specialty can optimize, as well as foster relationships that support multi-disciplinary patient-centered care.
The complex relationship of chronic pelvic pain of gynecologic origin, and systemic conditions has left us with an area to identify and optimize the role of surgery in delivering patient-centered care. While novel medical therapeutics are still lacking, evolving the means to diagnose and manage pelvic pain exist in our field as leaders and innovators that represent patients’ needs. An additional role that we have includes increasing access of care for this need. This can be through training key clinical groups, or providing specialty patient care, and innovative clinical education that bridges gaps in healthcare delivery for patients with chronic pelvic pain.
High volume surgical outcomes have key benefits in streamlining value-based care delivery. Similarly, high-volume pelvic pain clinical programs, can provide the necessary structured education for patient-centered care. Addressing pelvic pain, starts with a diagnosis and the tools to capture patient experiences, so that we can transition to a phase where healthcare systems afford greater access to care for all, and greater therapeutics or evidence-based pathways for the role of surgical management in chronic pain.
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