Last reviewed: November 2017
Last updated: November  2017

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • dysuria
  • dyspareunia
  • dysmenorrhoea
  • abdominal tenderness
  • abdominal trigger points
  • vestibular tenderness
  • rectal tenderness
  • levator ani tenderness
  • adnexal tenderness
  • cervical motion tenderness
  • uterine tenderness
  • bladder tenderness
  • urethral tenderness

Other diagnostic factors

  • abdominal pain
  • nocturia
  • incomplete voiding
  • headache
  • dyschezia
  • low back pain

Risk factors

  • sexual abuse
  • pelvic inflammatory disease
  • anxiety or depression
  • drug or alcohol abuse
  • pregnancy
  • polymenorrhoea
  • previous caesarean section
  • endometriosis
  • adhesions

Diagnostic investigations

1st investigations to order

  • urinalysis
  • urine culture
  • cervical swab
  • pelvic ultrasound
  • alkalinised lidocaine instillation into bladder
  • cystoscopy with hydrodistension
Full details

Investigations to consider

  • pelvic CT
  • pelvic MRI
  • laparoscopic biopsy
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Bradford W. Fenton

Consultant

Obstetrics and Gynecology

Independence Park Medical Services

Anchorage

AK

Disclosures

BWF has served as a consultant for Advance Medical and a Guidepoint Global Board Member for the International Pelvic Pain Society.

Dr Bradford W. Fenton would like to gratefully acknowledge the assistance of Dr Jennifer J. Schmitt in producing this monograph. JJS declares that she has no competing interests.

Peer reviewers VIEW ALL

Associate Professor and Chief

General Division of Obstetrics and Gynecology

University of Utah School of Medicine

Salt Lake City

UT

Disclosures

HS has been reimbursed for attending and participating in conferences on pelvic varicosity pain syndrome by Cook Inc.

Consultant Obstetrics

Obstetrics and Gynaecology

Middlesex Hospital

London

UK

Disclosures

CS declares that he has no competing interests.

Consultant Obstetrician and Gynaecologist

Barnet and Chase Farm Hospitals NHS Trust

Urogynaecology Services

Chase Farm Hospital

Enfield

UK

Disclosures

DS-O declares that he has no competing interests.

Use of this content is subject to our disclaimer