Chronic Pelvic Pain: Expert Care in Nairobi
Dr. Bruce Semo offers multidisciplinary treatment for chronic pelvic pain lasting >6 months at Irys Medical Center. Relief is Possible.
What Is Chronic Pelvic Pain?
Definition: Pain in the pelvic region (below umbilicus, above thighs) lasting ≥6 months, severe enough to cause functional disability or require medical care.
- Not a diagnosis — a symptom complex
- May be cyclic (worse with periods) or non-cyclic
- Affects 15–20% of women aged 18–50
Common Causes
Gynecological (60%)
- Endometriosis
- Adenomyosis
- Pelvic adhesions
- Ovarian remnant
Musculoskeletal (20%)
- Pelvic floor myofascial pain
- Levator ani syndrome
- Coccydynia
Urological (10%)
- Interstitial cystitis / Bladder pain syndrome
- Urethral diverticulum
Gastrointestinal (10%)
- Irritable bowel syndrome
- Chronic appendicitis
Key Symptoms
| Symptom |
Description |
Red Flag? |
| Dyspareunia |
Pain with intercourse (deep or entry) |
Common |
| Dysmenorrhea |
Severe period pain unresponsive to NSAIDs |
Common |
| Dyschezia |
Pain with bowel movements |
Possible IBS/Endo |
| Weight loss, fever |
Systemic symptoms |
Red Flag |
Diagnosis at Irys
1. History
Pain mapping, triggers, bowel/bladder diary
2. Exam
Abdominal, pelvic, trigger point assessment
3. Tests
Ultrasound, MRI, laparoscopy if needed
Treatment Options
Pelvic Floor Therapy
70% improvement
Biofeedback, manual release
Nerve Blocks
Pudendal, ilioinguinal
80% short-term relief
Medications
Gabapentin, amitriptyline, hormonal suppression
Pelvic Floor Physical Therapy
Goal: Reduce muscle tension, improve coordination, break pain cycle.
- Internal manual therapy
- Biofeedback training
- Home dilator program
- 12-week protocol
Targeted Nerve Blocks
Pudendal Nerve Block
Transgluteal injection
Relief in 4–6 hours
Ganglion Impar Block
For perineal pain
Day case procedure
Diagnostic & Therapeutic Laparoscopy
Indicated when: Suspected endometriosis, adhesions, or ovarian pathology.
- Excision of lesions
- Lysis of adhesions
- Preservation of fertility
Dr. Bruce Semo’s Chronic Pain Clinic
Every Wednesday 2–5 PM at Irys Medical Center
- Free initial pain mapping
- Pelvic floor therapist on-site
- Same-week nerve block
- Laparoscopy within 7 days
- Multidisciplinary team: Urologist, Gastroenterologist, Psychologist
“Pain is real. So is recovery.”
Book Pain Consult
Myths vs. Facts
Myth: "It’s all in your head"
Fact: Chronic pelvic pain has identifiable physical causes in >90% of cases.
Myth: "Hysterectomy cures all pain"
Fact: Only 60% success if no visible pathology.
Myth: "Pain is normal after childbirth"
Fact: Pain >6 weeks postpartum needs evaluation.
