Pelvic floor tenderness in the etiology of superficial dyspareunia

Paul J. Yong, Justin Mui, Allaire C, Catherine Allaire, Christina Williams, Williams C
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC · 2014 · vol. 36(11) , pp. 1002–1009 · doi:10.1016/s1701-2163(15)30414-x · PMID:25574678 · W2223634623
Observational OA: bronze CC0 ⤵ 23 in-corpus citations
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This study investigated pelvic floor tenderness as a contributing factor to superficial dyspareunia.

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Abstract

OBJECTIVE: To calculate the prevalence of pelvic floor tenderness in the population of women with pelvic pain and to determine its implications for symptoms of pelvic pain. METHODS: We conducted a retrospective review of patients with pelvic pain at a tertiary referral centre. Pelvic floor tenderness was defined as levator ani tenderness on at least one side during single digit pelvic examination. The prevalence of pelvic floor tenderness in this cohort of women with pelvic pain was compared with the prevalence in a cohort of women without pain attending a gynaecology clinic. In the women with pelvic pain, multiple regression was performed to determine which variables were independently associated with pelvic floor tenderness. RESULTS: The prevalence of pelvic floor tenderness was 40% (75/189) in the cohort with pelvic pain, significantly greater than the prevalence of 13% (4/32) in the cohort without pain (OR 4.61; 95% CI 1.55 to 13.7, P = 0.005). On multiple logistic regression, superficial dyspareunia (OR 4.45; 95% CI 1.86 to 10.7, P = 0.001), abdominal wall pain (OR 4.04; 95% CI 1.44 to 11.3, P = 0.005), and bladder base tenderness (OR 4.65; 95% CI 1.87 to 11.6, P = 0.001) were independently associated with pelvic floor tenderness. Pelvic floor tenderness was similarly present in women with or without underlying endometriosis. CONCLUSION: Pelvic floor tenderness is common in women with pelvic pain, with or without endometriosis, and is a contributor to superficial dyspareunia. Pelvic floor tenderness was also associated with abdominal wall pain and bladder base tenderness, suggesting that nervous system sensitization is involved in the etiology of pelvic floor tenderness.

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Condition tags

dyspareuniachronic_pelvic_pain

MeSH descriptors

Dyspareunia Pelvic Floor Pelvic Pain Adult Adult Dyspareunia Dyspareunia Female Female Humans Humans Middle Aged Middle Aged Pelvic Floor Pelvic Floor Pelvic Pain Pelvic Pain Retrospective Studies Retrospective Studies

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References (36)

Cited by (24)

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License: CC0 · commercial use OK