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
Other diagnostic factors
- dor abdominal
- noctúria
- micção incompleta
- cefaleia
- disquezia
- lombalgia
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
Diagnostic investigations
1st investigations to order
- urinálise
- urocultura
- teste de amplificação de ácido nucleico
- ultrassonografia pélvica
- instilação com lidocaína alcalinizada na bexiga
Investigations to consider
- tomografia computadorizada (TC) pélvica
- ressonância nuclear magnética (RNM) pélvica
- biópsia laparoscópica
- cistoscopia com hidrodistensão
Treatment algorithm
dor ginecológica
Cistite intersticial (síndrome da bexiga dolorosa)
fibromialgia
Síndrome do músculo elevador do ânus
vulvodinia
Contributors
Authors
Bradford W. Fenton, MD, PhD

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
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
American 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
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