Ultrasonographic evaluation of chronic pelvic pain

Nicole Brooks; Moshood Olatinwo

doi:10.1017/cbo9780511776854.025

Ultrasonographic evaluation of chronic pelvic pain

Nicole Brooks, Moshood Olatinwo

In: Ultrasonography in Reproductive Medicine and Infertility · 2010 · pp. 187–192 · doi:10.1017/cbo9780511776854.025 · W2257845406

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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-09 ⓘ

Transvaginal sonography can identify ovarian endometriomas but shows low sensitivity for vaginal/rectovaginal endometriosis, while MRI is better for adenomyosis and extraovarian endometriosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-11 · read from full text ⓘ

This chapter reviews ultrasonographic approaches for evaluating chronic pelvic pain in gynecologic populations, outlining major potential etiologies and the ultrasound role across conditions. It describes adenomyosis as endometrial glands and stroma within the myometrium, associated with chronic pelvic pain and related symptoms, and it also discusses other pelvic pain mechanisms such as pelvic inflammatory disease, postpartum or surgery-related infections, pelvic congestion syndrome from retrograde ovarian venous flow, and their characteristic symptom patterns. The chapter notes that patient satisfaction may improve when patients better understand their pain through ultrasound-based evaluation, but it does not provide a specific empirical study design or quantified diagnostic performance. Relevance to endometriosis: the chapter is focused on ultrasonographic evaluation of chronic pelvic pain and includes dedicated coverage of pelvic endometriosis alongside a separate adenomyosis chapter, placing both conditions within its imaging framework for chronic pelvic pain.

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Abstract

Ovarian cystic endometriosis, endometrioma, may present on ultrasonography as an easily identifiable hyper-refringent adnexal mass and the most frequent variation. Different studies have tried to evaluate the diagnostic capacity of transvaginal sonography (TVS) in deep endometriosis. When ultrasonographic findings were compared with surgical findings and pathology reports, a low sensitivity (around 30%) was reported for vaginal or rectovaginal septum endometriosis, with a high rate of false negatives. Infertile women with endometriosis have a higher prevalence of associated functional images, such as unruptured luteinized follicles, hydrosalpinges, adenomyosis, and/or intraovarian endometriosis that may interfere with oocyte retrieval. The role of TVS in the diagnosis of extraovarian endometriosis, an area where magnetic resonance imaging (MRI) has proved to be much more beneficial, is yet to be established. MRI offers a better suggestive diagnosis of adenomyosis than TVS due to its lower interobserver variability.

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- Ultrasonography in Reproductive Medicine and Infertility - Ultrasonography in Reproductive Medicine and Infertility - Copyright page - Dedication - Contents - Contributors - Foreword - Preface - Acknowledgments - Section 1: Imaging techniques - Section 2: Ultrasonography in infertility - Chapter 8 3D Ultrasonography and infertility - Chapter 9 Ultrasonography and diagnosis of polycystic ovary syndrome - Chapter 10 Ultrasonography and the treatment of infertility in polycystic ovary syndrome - Chapter 11 Ultrasonography of uterine fibroids - Chapter 12 Ultrasonography of the endometrium - Chapter 13 Ultrasonography of the cervix - Chapter 14 Color Doppler imaging of ovulation induction - Chapter 15 Ultrasonography of pelvic endometriosis - Chapter 16 Adenomyosis - Chapter 17 Congenital uterine malformations - Chapter 18 Uterine septum - Chapter 19 Ultrasonography and incidental ovarian pathology - Chapter 20 Scrotal ultrasonography in male infertility - Chapter 21 Transrectal ultrasonography in male infertility - Chapter 22 Ultrasonographic evaluation of acute pelvic pain - Chapter 23 Ultrasonographic evaluation of chronic pelvic pain - Section 3: Ultrasonography in assisted reproduction - Section 4: Early pregnancy after infertility treatment - Index from Section 2: - Ultrasonography in infertility Published online by Cambridge University Press: 07 September 2011 Edited by Book contents - Ultrasonography in Reproductive Medicine and Infertility - Ultrasonography in Reproductive Medicine and Infertility - Copyright page - Dedication - Contents - Contributors - Foreword - Preface - Acknowledgments - Section 1: Imaging techniques - Section 2: Ultrasonography in infertility - Chapter 8 3D Ultrasonography and infertility - Chapter 9 Ultrasonography and diagnosis of polycystic ovary syndrome - Chapter 10 Ultrasonography and the treatment of infertility in polycystic ovary syndrome - Chapter 11 Ultrasonography of uterine fibroids - Chapter 12 Ultrasonography of the endometrium - Chapter 13 Ultrasonography of the cervix - Chapter 14 Color Doppler imaging of ovulation induction - Chapter 15 Ultrasonography of pelvic endometriosis - Chapter 16 Adenomyosis - Chapter 17 Congenital uterine malformations - Chapter 18 Uterine septum - Chapter 19 Ultrasonography and incidental ovarian pathology - Chapter 20 Scrotal ultrasonography in male infertility - Chapter 21 Transrectal ultrasonography in male infertility - Chapter 22 Ultrasonographic evaluation of acute pelvic pain - Chapter 23 Ultrasonographic evaluation of chronic pelvic pain - Section 3: Ultrasonography in assisted reproduction - Section 4: Early pregnancy after infertility treatment - Index Adenomyosis is a common disorder in the gynecologic population that consists of the presence of endometrial glands and stroma in the myometrium. Adenomyosis is associated with chronic pelvic pain, dysmenorrhea, dyspareunia, and feelings of pressure low in the pelvis due to uterine enlargement. Infection of the pelvis causes pain by several different mechanisms: pelvic inflammatory disease, puerperal infections, postoperative gynecologic surgery, and abortion-related infections. Pelvic congestion syndrome (PCS) is a pelvic pain syndrome caused by retrograde flow in an incompetent ovarian vein. Symptoms associated with PCS include a shifting location of pain, deep dyspareunia, and postcoital pain, with exacerbation of symptoms after prolonged standing. Ultrasound is a very useful tool for evaluating chronic pelvic pain sufferers. Patients have better satisfaction due to their understanding of their pain, with a goal of better productivity and return to normal function. - Type - Chapter - Information - Ultrasonography in Reproductive Medicine and Infertility , pp. 187 - 192Publisher: Cambridge University PressPrint publication year: 2010 Accessibility compliance for the HTML of this chapter is currently unknown and may be updated in the future. To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle. Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply. Find out more about the Kindle Personal Document Service. - Ultrasonographic evaluation of chronic pelvic pain - - Book: Ultrasonography in Reproductive Medicine and Infertility - Online publication: 07 September 2011 To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox. - Ultrasonographic evaluation of chronic pelvic pain - - Book: Ultrasonography in Reproductive Medicine and Infertility - Online publication: 07 September 2011 To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive. - Ultrasonographic evaluation of chronic pelvic pain - - Book: Ultrasonography in Reproductive Medicine and Infertility - Online publication: 07 September 2011

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Condition tags

endometriosisadenomyosisendometriomachronic_pelvic_pain

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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 (24)

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License: CC0 · commercial use OK

[1] Accuracy of transvaginal sonography and rectal endoscopic sonography in the diagnosis of deep infiltrating endometriosis via openalex

[2] Chronic Pelvic Pain: Prevalence, Health-Related Quality of Life, and Economic Correlates via openalex

[3] Impact of diagnostic laparoscopy on the management of chronic pelvic pain via openalex

[4] Interventions for treating chronic pelvic pain in women via openalex

[5] The community prevalence of chronic pelvic pain in women and associated illness behaviour. via openalex

[6] The economic burden of intractable gynaecological pain via openalex

[7] The role of endovaginal ultrasound in differentiating endometriomas from other ovarian cysts via openalex

[8] The role of endovaginal ultrasound in differentiating endometriomas from other ovarian cysts. via openalex

[9] The role of ultrasound in the management of women with acute and chronic pelvic pain via openalex

[10] Transvaginal sonography in the diagnosis of adenomyosis: which findings are most accurate? via openalex

[11] Treatment of deeply infiltrating endometriosis via openalex

[12] W2064107649 via openalex

[13] doi:10.1007/s00270-007-9160-0 via openalex

[14] W2089610285 via openalex

[15] W2027716108 via openalex

[16] W2025414707 via openalex

[17] W2167613032 via openalex

[18] W1972123477 via openalex

[19] W2478065572 via openalex

[20] W3201418652 via openalex

[21] W6610745239 via openalex

[22] W6639136399 via openalex

[23] W2033623995 via openalex

[24] W10868991 via openalex