Anterior Vaginal Wall Tenderness (AVWT) as a Physical Symptom in Chronic Pelvic Pain

John D Paulson, Joseph N Paulson
JSLS : Journal of the Society of Laparoendoscopic Surgeons · 2011 · vol. 15(1) , pp. 6–9 · doi:10.4293/108680810x12924466008961 · PMID:21902934 · W2050254678
article OA: hybrid CC0 ⤵ 8 in-corpus citations
📄 Open PDF View on OpenAlex View on PubMed View at publisher

Abstract

BACKGROUND AND OBJECTIVES: Chronic pelvic pain is often difficult to diagnose and treat properly. Physicians called on to treat this problem may not be able to give a specific diagnosis. The aim of this study was to see whether the physical presence of anterior vaginal wall tenderness could help narrow down and elucidate diagnoses in a practice focusing on diagnosis and treatment of chronic pelvic pain. METHODS: The study cohort comprised 284 patients with chronic pelvic pain limited to gynecologic and lower urinary problems. Histories, physical examinations, and endoscopic procedures were performed on each patient. An analysis of this information was conducted. RESULTS: Of the chronic pelvic pain patients, 78% had endometriosis, 81% had interstitial cystitis, and 61% had both concurrently. The sensitivity of anterior vaginal wall tenderness (AVWT) in patients with interstitial cystitis was 95%, and in those with only endometriosis and no interstitial cystitis, the sensitivity was 17%. The positive predictive value for interstitial cystitis was 85%, and for endometriosis it was 67%. CONCLUSIONS: Examination of the anterior vaginal wall with an empty bladder at the initial examination can lead one to suspect interstitial cystitis and possibly either concomitant or singular endometriosis and allow the physician to approach the workup accordingly.

My notes (saved in your browser only)

Condition tags

mesh:D004715mesh:D017699endometriosischronic_pelvic_paininterstitial_cystitis

MeSH descriptors

Pelvic Pain Pelvic Pain Vagina Vagina Adult Chronic Disease Cystitis, Interstitial Cystitis, Interstitial Endometriosis Endometriosis Female Humans Middle Aged Pain Measurement Pelvic Pain Pelvic Pain Physical Examination

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (15)

Cited by (8)

Source provenance

europepmc
last seen: 2026-06-04T01:30:01.192114+00:00
openalex
last seen: 2026-06-04T00:00:01.174412+00:00
pubmed
last seen: 2026-05-13T22:16:35.898691+00:00
License: CC0 · commercial use OK