Pelvic Pain Centre

[ChiangMaiThai]

In both men and women, a myriad of symptoms are now classified under the term "chronic pelvic pain syndrome". These symptoms are usually quite unpleasant, have a very large impact on one's quality of life, and in many cases are constant. They often times mirror symptoms of bacterial infections and disease of the various organs, but without any infection or abnormality of the organs present. For example, one may have all the symptoms of an enlarged prostate without any evidence that it is actually enlarged. Or all the symptoms of a urinary tract infection, with no pathogen found.

In the US, there are now dozens of dedicated pelvic pain centres that address these problems. They are able to help many patients via numerous methods. Increasingly they are finding success by looking at the symptoms as a result of chronic pelvic muscle tension, which is addressed via medications, long term physical therapy and training in relaxation of the pelvic floor muscles. Sometimes nutrition, herbs, and lifestyle changes can improve symptoms. In other cases, surgery is recommended, and when all else fails, they will at the very least work to help the patient cope by way of narcotic pain medications.

After much research I can find not even one such centre anywhere in Asia, which is quite shocking to me. Is anyone aware of any hospital in Asia that has even one doctor who specializes in this?

Indeed, simply finding a single doctor in Thailand who has any knowledge or ability to help has not been possible.

The great Bumrungrad informed me that 'there is nothing much we can do' and did not even invite me in for an appointment. When I advised as to the above and suggested that they may want to send a team of doctors to the US, they remarked that it is not in their plans.

At Samitivej, I was given a very rudimentary examination before being declared normal and advised to 'play golf in order to take my mind off it'. Upon describing my symptoms (of which a quick Google search will show you are not completely unusual) to The Thai Association for the Study of Pain, I was told that they 'had no idea'. When I inquired into meeting with a specialist regarding pain management, I did not hear back from them.

Luckily I will be able to travel to the US if that's what it comes to. But my heart goes out to all those suffering in this region who are currently faced with these kinds of responses from the top hospitals. And without being too critical or antagonistic, I genuinely can not fathom how doctors who have dedicated their lives to helping people do not take immediate interest when conditions that they deem as 'untreatable' are cured by doctors in another country.

[ChiangMaiThai]

Ten days later I am still shocked. Even simple outpatient procedures such as Pudendal Nerve Blocks (which are commonplace in the US, take 20 minutes, and can provide huge relief when administered in a series of four injections, each 4 weeks apart) seem to be a complete mystery to Asia's best hospitals. Whey don't the hospitals here keep up to date with those in the US and Europe? Surely if they want to bill themselves as 'world class', they need to offer procedures that are commonplace in the West?

[InterestedObserver]

If you are trying to compare Thai and US healthcare facilities, there is no comparison. Both have their pros and cons.

Edited March 25, 2011 by InterestedObserver

[bina]

doctors do not neccessarily choose specialities because they want to help humans but choose what will be good business: in america pain management is now a popular profession; here, fertility problems is high on the list. the public demands it and the doctors provide it. in thailand, pain management is probably not a highly requestion 'product'. how many tropical medical clinics are there in iowa compared to thailand? brucellosis is still prevalent here, and doctors study it, and recognize it. probably less so in a country that doesnt have a problem with brucellosis (do to proper herd management/vaccinations).

plastic surgery is a big deal in thailand. psychiatry and psychology are probably lagging behind in thailand , since there is not a high demand (nor recognition of the problems,although the problem exits). in the states, there is even canine psychiatry because there is a demand for it.

bina

[Sheryl]

I suspect pain management would be plenty popular if people had the option and knew it existed.

This (and the related area of palliative/hospice care) just happens to be an area where Thailand is way behind the West. Both the knowledge and attitudes of medical professionals and the expectations of the general public are circa 1970 in comparison to the West whereas in many other areas Thailand is up to date or virtually so.

I have not researched this with regard to other Asian countries, can only speak for Thailand.

[katana]

Ten days later I am still shocked. Even simple outpatient procedures such as Pudendal Nerve Blocks (which are commonplace in the US, take 20 minutes, and can provide huge relief when administered in a series of four injections, each 4 weeks apart) seem to be a complete mystery to Asia's best hospitals. Whey don't the hospitals here keep up to date with those in the US and Europe? Surely if they want to bill themselves as 'world class', they need to offer procedures that are commonplace in the West?

I don't think it's much better in other countries.

Apparently there are only about 4 doctors trained to do pudendal nerve blocks in the whole of the UK.

[ChiangMaiThai]

doctors do not neccessarily choose specialities because they want to help humans but choose what will be good business: in america pain management is now a popular profession; here, fertility problems is high on the list. the public demands it and the doctors provide it. in thailand, pain management is probably not a highly requestion 'product'. how many tropical medical clinics are there in iowa compared to thailand? brucellosis is still prevalent here, and doctors study it, and recognize it. probably less so in a country that doesnt have a problem with brucellosis (do to proper herd management/vaccinations).

plastic surgery is a big deal in thailand. psychiatry and psychology are probably lagging behind in thailand , since there is not a high demand (nor recognition of the problems,although the problem exits). in the states, there is even canine psychiatry because there is a demand for it.

bina

I suspect that various pelvic pain conditions effect Asians and Westerners equally. It is only recently that doctors in the US have realized that in many cases they are dealing with a neuromuscular condition. They have been quick to set up centres that specialize in different treatment options. Unfortunately, those people in Asia who go to the region's 'best' hospitals with these symptoms will be tested for the obvious (infections, organ diseases, etc), in most cases cleared, and then told to go home and try not to think about it.

The simple truth is that Asian hospitals are simply behind in this field.