Childs, a gynecologist with Ob-Gyn South at Brookwood Hospital, says he is one of the only pelvic pain specialists in Alabama. “As I was into my residency program, I recognized a deficit in my education and training regarding how to take care of these patients. I became interested in further developing my ability to care for patients with chronic pelvic pain from a gynecological standpoint,” he says.
Childs did a two-year clinical fellowship in chronic pelvic pain and advanced gynecologic laparoscopy in Birmingham under his former mentor and founder of his practice, the late Dr. Paul Perry. “He trained me, and I fell in love with the practice and the whole idea of treating patients with pelvic pain. I joined the practice and have been here ever since,” Childs says.
The most common conditions that Childs treats include endometriosis, irritable bowel syndrome, and interstitial cystitis. “There is a group of diseases and conditions I take care of that are not as well-known, but create a lot of problems in patients with chronic pelvic and pelvic floor muscle pain. These include patients who have vaginal muscle spasms and can’t have intercourse, those who have difficulty with defecation which goes along with urination issues as well,” he says.” I also have patients with vestibulitis or vestibulodynia which is pain at the entrance to the vagina and are unable to have penetration associated with intercourse and can’t even use tampons. I also see women who have nerve entrapment situations that can result from incisions during surgery.”
Childs has discovered that many of his patients see five or more physicians for their problems prior to being referred to his practice. “Some treatments we do are simple, but most patients have complex issues requiring complex treatment plans,” he says. “Women who suffer with chronic pelvic pain can be emotionally separated from their families because of depression. Painful intercourse can disrupt relationships, and chronic pain leads to significant loss of time from work.”
All Ob/Gyns treat pelvic pain issues to some degree, but Childs says most don’t have the time to see a lot of these time-intensive patients. “Most Ob/Gyns don’t have as much time to spend with these patients when they are seeing about 40 total patients each day,” he says. “I no longer treat OB patients, so this is truly my focused profession. I am fully dedicated to the care and evaluation of patients with chronic pelvic pain in a gynecological setting.”
Initial patient encounters in Childs’ office take an hour or longer and are centered on discovering as many sources of a patient’s pain as possible. That involves an extensive history and review of any previous records with radiographic and surgical reports and prior treatments. “Frequently, I obtain an ultrasound while patients are in my office during initial visits. My examination focuses on causes of abdominal and pelvic pain and includes examination of the abdomen, gynecological organs, and abdominal and pelvic muscles,” Childs says.
Most of Childs’ patients are referrals from other ObGyns. He says that any patient who makes a cold call to his office on her own for an appointment could wait about six months for a scheduled visit. “The vast majority of my patients are referred to me by general Ob/Gyns. I suggest patients experiencing chronic pain first consult with their gynecologist,” Child says. “If there are difficult or complex cases involving ongoing pain, often gynecologists or other providers will refer the patients to me. I don’t practice general gynecology, so patients will continue to see their gynecologists for routine care.”
Childs remembers all the patients with chronic pelvic pain that he encountered during his OB/GYN residency, and he is glad he decided to specialize in the field. “When treatments lead to improvement or even resolution of pain, families and relationships can be restored and women can rebuild their lives. This is the goal of our specialty,” he says.