Pelvic pain is not a diagnosis. It is a symptom that needs an explanation.
Chronic pelvic pain, severe period pain, pain with sex, pain with bowel movements, and pain with urination may reflect endometriosis, adenomyosis, fibroids, adhesions, ovarian cysts, or other treatable disease. CIGC looks for the cause rather than masking symptoms.
If you have been told your imaging is normal, your pain is unexplained, or you have already tried medication without answers, a surgical specialist evaluation may change the direction of care.
- 🎓 GYN-Oncology Trained
- ✏ Surgery Only — Not Obstetrics
- 📋 6 Peer-Reviewed Publications
- ✅ 20,000+ Procedures Performed
- 📍 Rockville, MD · Reston, VA · Secaucus, NJ
Pelvic pain is not a diagnosis — it is a symptom that needs an explanation
Pain medication, hormones, and reassurance do not answer the most important question: what is causing the pain? CIGC evaluates pelvic pain as a surgical problem when symptoms suggest endometriosis, adenomyosis, fibroids, adhesions, ovarian cysts, or complex pelvic disease.
Patterns Matter
- Pain that worsens over time
- Pain with cycles
- Pain with sex
- Pain with bowel movements or urination
Often Missed
- Normal ultrasound
- No clear diagnosis
- Repeated ER or OB/GYN visits
- Years of symptoms without answers
CIGC Goal
- Identify the cause
- Treat the disease when surgery is appropriate
- Avoid endless symptom management
- Use specialist-level evaluation
Most pelvic pain has a structural, surgically treatable cause. Find yours here.
CIGC specializes in identifying and treating the most common GYN causes of pelvic pain. Review each condition below — then see the operative record for what CIGC has achieved treating each one.
Endometriosis
Symptoms
Severe pain with the menstrual cycle, heavy bleeding, pelvic pressure, pain with intercourse, and infertility. Pain is often progressive — worsening each cycle as the disease advances.
Diagnosis
Cannot be made with imaging. Ultrasound, MRI, and CT cannot diagnose endometriosis. Only laparoscopic surgery can confirm the disease, stage it (I–IV), and determine its full extent on all organs.
Treatment
Complete laparoscopic excision of all disease — including involvement of the bowel, bladder, ureters, and diaphragm. Retroperitoneal technique removes disease from behind the peritoneal lining. Ablation (burning) is not appropriate — it leaves disease behind and leads to recurrence.
Fibroids
Symptoms
Heavy bleeding, pelvic pain and pressure, urinary frequency, bloating, and abdominal distension. Severity increases with fibroid size and number.
Diagnosis
Ultrasound is the best single method — inexpensive and highly accurate for evaluating the number, size, and location of fibroids.
Treatment
LAAM myomectomy removes all fibroids of any size or number through two small incisions — uterus preserved, back to work in 7–14 days. For patients not preserving the uterus, DualportGYN hysterectomy uses the same two incisions, same-day. UFE is not recommended for fertility patients — not FDA-approved and can increase miscarriage risk. UFE can also dramatically increase pelvic pain for weeks after treatment.
Adenomyosis
Symptoms
Very severe menstrual pain, heavy bleeding, and back pain. Symptoms are incapacitating and often far more severe than typical cramping. Most OB/GYNs do not diagnose it.
Diagnosis
Ultrasound is frequently normal. MRI can detect it in some cases. Diagnosis is primarily clinical — through careful evaluation of symptoms. Adenomyosis is routinely missed because imaging does not show it.
Treatment
Functional Partial Hysterectomy — uterus removed, cervix and ovaries preserved, no surgical menopause, pelvic floor support maintained. Same-day discharge, back to work in one week. Fibroids and endometriosis can be treated simultaneously.
Ovarian Cysts & Pelvic Masses
Symptoms
Gradual pain as the cyst grows, abdominal distension — or sudden severe pain if the cyst twists (torsion), a surgical emergency.
Diagnosis
Ultrasound is most accurate — evaluates size and characteristics. GYN-oncology training allows safe differentiation of benign cysts from masses requiring further assessment.
Treatment
Laparoscopic cyst removal preserving the ovary wherever possible. Removal of the ovary is almost never necessary for younger patients, yet is commonly performed unnecessarily by OB/GYNs. Open surgery is not required even for very large masses.
Adhesions
Symptoms
Constant pelvic pain in patients with a history of prior surgery, C-section, endometriosis, or pelvic infection. Pain is continuous rather than cyclical.
Diagnosis
Cannot be made with imaging. Adhesions are too thin to be seen on ultrasound, CT, or MRI. Only laparoscopic surgery confirms and treats them.
Treatment
Laparoscopic lysis of adhesions — surgical removal of scar tissue binding organs. Requires a specialist: non-specialist OB/GYNs attempting adhesion removal significantly increase the risk of bowel injury. Bowel, bladder, and ureter repair may be required in the same procedure.
Interstitial Cystitis (IC)
Symptoms
Pelvic pain, bladder pain and pressure, pain with urination, urinary urgency. Frequently misdiagnosed as recurrent UTIs or dismissed entirely.
Diagnosis
Clinical symptoms and cystoscopy with hydrodistension. IC and endometriosis coexist in up to 80% of patients — both must be evaluated or pain persists after treating only one.
Treatment
Hydrodistension and dietary modification. The critical point: IC is almost never the only cause. CIGC evaluates every pelvic pain patient for IC simultaneously with the surgical GYN evaluation so that coexisting disease is identified and treated together.
Irritable Bowel Syndrome (IBS)
The Problem
IBS is an uncommon cause of pelvic pain. OB/GYNs give patients this diagnosis far too often without justification — while endometriosis, adenomyosis, fibroids, adhesions, or IC go undiagnosed and untreated.
What to Do
IBS should not be a wastebasket diagnosis for pelvic pain. If you have been told your pain is IBS without a surgical evaluation, seek a CIGC second opinion. A surgical evaluation will confirm or rule out a structural, treatable cause.
Ready to find out if CIGC is right for you?
Schedule a consultation — reviewed by Dr. Danilyants or the surgical team. In-network. Rockville, MD · Reston, VA · Secaucus, NJ · Telehealth.
Thank you — we’ve received your request.
A member of the CIGC surgical team will review your information and reach out shortly. For immediate assistance, call 1-888-SURGERY.
Dr. Natalya Danilyants developed the surgical techniques used at CIGC and has published their outcomes in peer-reviewed medical journals. Every CIGC surgeon is personally trained in these techniques and performs surgery according to the same operative standards and quality benchmarks — whether your procedure is performed in Maryland or New Jersey.
One specialist. Every cause. Same-day surgical resolution.
Dr. Danilyants developed the surgical techniques used at CIGC and published outcomes across six peer-reviewed studies. Every CIGC surgeon is trained in her methods and operates to the same published standards — whether your procedure is performed in Maryland or New Jersey.
One team of pelvic surgery experts handles every condition above — no referrals to general surgeons or urologists
- GYN-oncology training covers surgery on bowel, bladder, ureters, vessels, and diaphragm — the structures every condition above can involve
- Most MIS surgeons refer complex cases out. CIGC does not. One team. One procedure. One same-day discharge home.
- Endometriosis, adenomyosis, fibroids, ovarian cysts, and adhesions can all be identified and treated in a single procedure
Diagnosis and treatment in one minimally invasive procedure — not years of referrals
- Most pelvic pain patients wait 7 to 10 years for an endometriosis diagnosis — and for adenomyosis, the diagnosis can take even longer, as imaging is frequently normal and most OB/GYNs do not recognize it
- Imaging such as ultrasound cannot diagnose endometriosis, adenomyosis, or adhesions — only surgery confirms them, stages the disease, and removes it
- Watching and waiting for fibroids is a common approach used by OB/GYNs, but allows progression of disease — increasing size of the fibroids, heavier bleeding, and more severe pain
- At CIGC, the diagnosis is confirmed and the disease removed in one minimally invasive procedure, allowing you to go home the same day
- For fertility patients: excision of endometriosis restores normal anatomy, decreases inflammation, and can enhance fertility. Removal of fibroids provides almost immediate relief of pain and heavy bleeding, and restores the uterus to normal size allowing for fertility.
Surgery resolves — medication suppresses
- Pain pills and birth control suppress symptoms. The disease is not removed. Symptoms return when medication stops.
- CIGC surgically removes the cause and provides immediate, lasting relief
- For fertility patients: excision restores normal anatomy, decreases inflammation, and can enhance fertility
In-network — no cash payment to your surgeon required
- Covered by most major insurance plans — no cash payment for the highest level of pelvic pain surgical care
- Cash-based specialists charge $20,000+. CIGC accepts your insurance.
Why pelvic pain is so often misdiagnosed — and what to do about it
Dr. Danilyants explains why chronic pelvic pain patients wait years for a correct diagnosis, what the most common surgical causes are, and why surgery resolves what medication never can.
What CIGC has achieved treating each condition — verified and published
From more than 20,000 minimally invasive GYN procedures, published in peer-reviewed journals. Whatever is causing your pain, CIGC has treated it — at a complexity the worldwide literature documents only as multi-day hospital admissions — and sent the patient home the same day.
The point is not the records. The point is what the records prove. Whatever is causing your pain — however long it has been dismissed, however advanced the disease — CIGC can find it, remove it completely, and send you home the same day. Your case is within this range.
Three things CIGC has demonstrated simultaneously through actual data and published literature that no other pelvic pain practice has achieved
Every claim below is sourced from CIGC’s peer-reviewed published journal articles and actual data from patients who have undergone surgery at CIGC.
The most complex pelvic pain cases — same-day, surgery center, one team
A 32 cm endometrioma. Nearly 15 lbs of fibroids. Stage IV endometriosis on bowel, bladder, and diaphragm. Complex adhesions. All treated same-day, all at a freestanding surgery center, all by one team of GYN-oncology trained surgeons — without involving a general surgeon or urologist. No published series documents this range of same-day complexity.
Diagnosis confirmed and disease removed in one procedure
Endometriosis and adhesions cannot be diagnosed by imaging. At CIGC, a single minimally invasive procedure confirms the diagnosis, stages the disease, and removes it completely — the cause that eluded 7 to 10 years of referrals found and treated in one same-day procedure. Back to work in about one week.
Covered by most major insurance — no cash payment required
Cash-based pelvic pain specialists charge $20,000 or more for care available in-network at CIGC. CIGC performs the most complex pelvic pain cases at a freestanding surgery center at more than 65% lower cost than the hospital, covered by most major insurance plans. No cash payment required.
What a star rating does not tell you about your pelvic pain specialist
A 4.9-star rating tells you patients were satisfied. It does not tell you whether surgery confirmed and removed the cause, whether your surgeon can treat disease on bowel and bladder without a general surgeon, or whether those reviews were collected before or after any surgery occurred.
Can your specialist find a cause that imaging cannot? Endometriosis and adhesions cannot be diagnosed by ultrasound, CT, or MRI. A specialist who evaluates pelvic pain without offering a surgical evaluation is working with incomplete information — and will almost certainly miss the cause.
Many practices collect patient reviews through automated services that send a survey immediately after a consultation — before any surgery has occurred. CIGC and Dr. Danilyants do not do this. Every CIGC review is a post-surgery review. Read them yourself: you will find patients describing years of dismissed pain — and the surgery that ended it.
Does your surgeon publish outcomes in peer-reviewed journals? CIGC does. Six publications. A satisfied patient after a basic laparoscopy is not the same evidence as published outcomes documenting complete excision of Stage IV disease — including the 32 cm case sent home the same day.
The average pelvic pain patient waits 7 to 10 years for a correct diagnosis. That delay — and the pain filling it — is what CIGC was designed to end.
Patients who were dismissed, misdiagnosed — and then found CIGC
“I had seen 4 GYNs, all of whom told me my pain was not GYN. CIGC operated and since that day, almost two years ago, I’ve been a much happier person. I highly recommend CIGC to anyone with endometriosis.”
“I had been suffering for years. Moved from IL to MD — CIGC saved my life. I went through 4 prior surgeries for severe endometriosis and adenomyosis that were damaging other organs. I have not felt this great in years.”
“CIGC removed a HUGE 19 cm endometrioma attached to my bowel, bladder, ovary and tubes. Up and walking 3 days later. Three months on, no pain. I was in debilitating pain every day. CIGC gave me my life back.”
“My current OB/GYN didn’t take my symptoms seriously — extreme pain during my cycle for years, it kept getting worse. All she stated was ‘you just need to get pregnant.’ I had endo and adeno. Don’t wait like I did.”
“I cried tears of joy when my first period after surgery had no pain. CIGC found a solution to my 2+ decades of suffering that countless doctors dismissed. All my concerns were taken seriously. This team is extraordinary.”
“I over-research everything. When I needed surgery for Stage IV endo I read all of the CIGC published papers. These surgeons have the lowest complication rates anywhere. Don’t have your regular OB/GYN do your surgery. Hands down, the best.”
Patient testimonials reflect individual experiences; individual results vary.
The peer-reviewed evidence behind the outcomes
Every clinical claim on this page is sourced from peer-reviewed, PubMed-indexed publications. CIGC does not publish marketing claims; it publishes data.
A Retroperitoneal Approach to Endometriosis Excisions: Surgical Outcomes and Seven-Year Follow-up
Seven-year follow-up on RET outcomes for complete endometriosis excision — including Stage IV disease on bowel, bladder, ureters, and diaphragm. All cases same-day discharge from a freestanding surgery center. Longest published outcome record for endometriosis excision at a freestanding ASC.
Laparoscopic-Assisted Abdominal Myomectomy with Bilateral Uterine Artery Occlusion / Ligation
1,313-patient comparison of LAAM vs. robotic, laparoscopic, and open myomectomy at Holy Cross Hospital, Maryland. LAAM produced the lowest complication rate, lowest conversion to open surgery (0.7%), and most fibroids removed per case of any approach. Largest published myomectomy comparison study.
LAAM: Surgery Center vs. Outpatient Hospital
816-patient comparison of LAAM performed at CIGC’s ASC vs. a hospital outpatient department — same surgeons. ASC: 98% same-day discharge, transfusion rate 2.0% vs. 6.5% at the hospital. No difference in fibroid burden removed. Confirms LAAM is safe and superior at the freestanding surgery center.
LAAM at a Freestanding Ambulatory Surgery Center: A Case Series
969-patient case series documenting LAAM outcomes at a freestanding ASC. Confirms LAAM can be performed safely in the ambulatory surgery center even in women who are morbidly obese. Supports same-day discharge as the standard — not the exception — for minimally invasive fibroid removal.
A Value-Based Evaluation of Minimally Invasive Hysterectomy Approaches
2,689-patient retrospective comparison at Holy Cross Hospital, Maryland — largest published study of its kind. CIGC’s laparoscopic retroperitoneal hysterectomy produced the highest value score of all six approaches: lowest intraoperative complication rate (2.1%), shortest operative time. Robotic hysterectomy had the highest postoperative complication rate (11.4%) and highest cost — with no outcome advantage.
Value-Based Assessment of Hysterectomy Approaches
Companion publication confirming value findings in the same 2,689-patient cohort. Documents cost differential across all minimally invasive hysterectomy approaches and confirms the laparoscopic retroperitoneal approach as the highest-value option of all studied. Robotic hysterectomy: highest cost, no outcome advantage.
Laparoscopic Hysterectomy Outcomes: Hospital vs. Ambulatory Surgery Center
2,031 patients, same surgeons, same procedure — hospital outpatient department vs. CIGC’s freestanding ASC. ASC: 99.8% same-day discharge vs. 88% at the hospital. ASC patients had shorter operative times and lower blood loss. Equivalent complication rates — confirming complex hysterectomy at a freestanding surgery center is safe, reproducible, and more cost-effective than the hospital setting.
Pelvic pain is a symptom, not a diagnosis. The goal is finding the cause rather than masking symptoms with repeated medication, referrals, or reassurance when pain continues.
Schedule Your CIGC Surgical Consultation
Your case will be reviewed by Dr. Danilyants or a member of the CIGC surgical team to determine the best treatment plan for your specific situation.
In a consultation, a CIGC specialist reviews your imaging, surgical history, and prior diagnoses — and explains what a surgical evaluation can find and treat, using your in-network insurance benefits. Consultations in Rockville, MD · Reston, VA · Secaucus, NJ · Telehealth.
Thank you — we’ve received your request.
A member of the CIGC surgical team will review your information and reach out shortly. For immediate assistance, call 1-888-SURGERY.
Monday – Friday, 8 am – 5 pm ET · Rockville, MD · Reston, VA · Secaucus, NJ