• Eg Adhesiolysis, hysterectomy, neurectomy
• The symptomatic effect of surgical procedures for chronic pelvic pain (CPP) relies on the modulation or interruption of the pelvic neural pain transmission
• Often successful if a related pathological finding is believed to be the possible cause of the symptoms even at the clinical stage

Neuroablation

• Eg Chemical neuroablation, radiofrequency thermocoagulation, pulsed or cooled radiofrequency, cryoneurolysis
• Used for abdominal wall or pelvic floor neuralgia, it directly destroys neural tissue or alters neural conduction
• More studies are needed before this can be recommended

Laparoscopy

• If a pelvic abnormality is suspected, laparoscopy is performed to confirm diagnosis & to treat contributing conditions (endometriosis, adhesions, or both)
• The mainstay of both diagnosis & surgical treatment of CPP in women

Transurethral resection (Coagulation & Laser)

• May be considered in patients with bladder pain syndrome type 3C if conventional treatments are ineffective
• Reports suggest that transurethral laser results in prolonged alleviation of pain & urgency

Open surgery

• Should only be considered for patients with bladder pain syndrome after all other therapies have failed
• Some reports suggest that cystectomy with ileal conduit formation or supratrigonal cystectomy with bladder augmentation may provide relief from bladder pain