Cotton-tipped applicator test: validity and reliability in chronic pelvic pain

Maryam Nasr‐Esfahani, John Jarrell
In: American Journal of Obstetrics and Gynecology · 2012 · vol. 208(1) , pp. 52.e1–52.e5 · doi:10.1016/j.ajog.2012.11.005 · PMID:23159690 · W1967466296
article OA: bronze CC0 ⤵ 16 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study evaluated the validity and reliability of using cotton-tipped applicators to assess chronic pelvic pain.

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Abstract

ObjectiveWe sought to assess the concurrent validity and interrater reliability of the cotton-tipped applicator (CTA) test as a screening tool for diagnosis of cutaneous allodynia in patients with viscerally related chronic pelvic pain (CPP).Study designWe performed a prospective cohort comparative observational study of referred patients to a gynecology clinic with CPP. A total of 22 females with CPP were compared to 23 pain-free controls and 12 cyclic pain patients. Participants were evaluated by 2 clinicians. The CTA test was performed to detect the appearance of pain in dermatomes of T10-L1.ResultsInterrater reliability resulted in 98% agreement for the 3 study groups. CTA test showed 73% sensitivity and 100% specificity for differentiating patients with CPP from pain-free patients.ConclusionThe CTA test had excellent interrater reliability and concurrent validity for diagnosis of cutaneous allodynia in CPP patients with visceral diseases versus controls.

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chronic_pelvic_pain

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