Clinics in general practice. A case for the gynaecologist?

The case of a 31-year-old female patient with 2 children who was sterilized 7 years ago at age 24 years and has a 3-year history of low bilateral abdominal pain is discussed. The patient was investigated at the surgical outpatient department and has been recommended to a gynecologist. The symptoms lack suggestion of gynecological disease. Some of the questions to be asked are why she was sterilized, why not her husband, and what method was used. Were there any complications in sterilization operations 7 years ago that resulted in abdominal pain? Whoever takes on the case should question what the quality of the woman's life was before the operation and how it has since changed. It would be helpful to know if she would have liked a 3rd child and if her sexual feelings have changed. At the time she was sterilized, it was unusual for a woman to be sterilized at the age of 24 years with 2 children. There were probably strong medical or psychiatric indications then. One suspects either tubal disease after sterilization or chronic pelvic inflammatory disease as the likely diagnosis. If it becomes apparent that she wants another baby perhaps tubal reanastomosis could be accomplished.