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Dor pélvica crônica em mulheres

Last reviewed: 17 Aug 2025
Last updated: 22 Jul 2025

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • disúria
  • dispareunia
  • dismenorreia
  • pontos-gatilho abdominais
  • dor à palpação do músculo elevador do ânus
  • dor à mobilização do colo
  • sensibilidade uterina
  • desconforto abdominal
  • dor à palpação vestibular
  • dor à palpação do reto
  • dor à palpação anexial
  • dor à palpação da bexiga
  • dor à palpação uretral
Full details

Other diagnostic factors

  • dor abdominal
  • noctúria
  • micção incompleta
  • cefaleia
  • disquezia
  • lombalgia
Full details

Risk factors

  • abuso sexual
  • doença inflamatória pélvica
  • higiene precária
  • ansiedade ou depressão
  • Uso de drogas ou consumo de bebida alcoólica
  • gestação
  • polimenorreia
  • parto cesáreo prévio
  • endometriose
  • aderências
Full details

Diagnostic investigations

1st investigations to order

  • urinálise
  • urocultura
  • teste de amplificação de ácido nucleico
  • ultrassonografia pélvica
  • instilação com lidocaína alcalinizada na bexiga
Full details

Investigations to consider

  • tomografia computadorizada (TC) pélvica
  • ressonância nuclear magnética (RNM) pélvica
  • biópsia laparoscópica
  • cistoscopia com hidrodistensão
Full details

Treatment algorithm

ONGOING

dor ginecológica

Cistite intersticial (síndrome da bexiga dolorosa)

fibromialgia

Síndrome do músculo elevador do ânus

vulvodinia

Contributors

Authors

Bradford W. Fenton, MD, PhD
Bradford W. Fenton

Consultant

Obstetrics and Gynecology

Independence Park Medical Services

Anchorage

AK

Disclosures

BWF is the author of an article cited in this topic.

Acknowledgements

Dr Bradford W. Fenton would like to gratefully acknowledge the assistance of Dr Jennifer J. Schmitt in producing this topic.

Disclosures

JJS declares that she has no competing interests.

Peer reviewers

Daniel Breitkopf, MD

Associate Professor & Department Chair

Department of Obstetrics and Gynecology

Mayo Clinic

Rochester

MN

Disclosures

DB declares that Mayo Clinic has received research payments from Bayer AG on his behalf for an Essure study.

Chris Spencer, MD

Consultant Obstetrics

Obstetrics and Gynaecology

Middlesex Hospital

London

UK

Disclosures

CS declares that he has no competing interests.

Dan Selo-Ojeme, MBA, FWACS, FMCOG, MRCOG

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.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

American College of Obstetricians and Gynecologists' Committee on Practice Bulletins-Gynecology. ACOG Practice bulletin no. 218: chronic pelvic pain. Obstet Gynecol. 2020 Mar;135(3):e98-109. Abstract

​A​merican College of Obstetricians and Gynecologists. Practice bulletin no. 114: management of endometriosis. Jul 2010 [internet publication].Full text

European Association of Urology. Guidelines on chronic pelvic pain. Mar 2025 [internet publication].Full text

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Differentials

    • Endometriose
    • Adenomiose
    • Doença inflamatória pélvica crônica
    More Differentials
  • Guidelines

    • Chronic pelvic pain
    • ACR appropriateness criteria: endometriosis
    More Guidelines
  • Patient information

    Síndrome do intestino irritável: perguntas a fazer ao seu médico

    Fibromialgia: o que é?

    More Patient information
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