Pain referral patterns in the pelvis

Lawrence Demco
In: The Journal of the American Association of Gynecologic Laparoscopists · 2000 · vol. 7(2) , pp. 181–183 · doi:10.1016/s1074-3804(00)80037-7 · PMID:10806259 · W1966268935
article OA: closed CC0 ⤵ 6 in-corpus citations
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This paper describes the typical patterns of pain referral from specific pelvic structures and their clinical implications.

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Abstract

Study objectiveTo determine if right-left pelvic pain orientation exists in all patients, and to estimate the frequency of pain referral patterns in the pelvis.DesignProspective, nonrandomized trial (Canadian Task Force classification II-1).SettingUniversity-affiliated hospital.PatientsOne hundred consecutive women with no pain undergoing tubal sterilization or investigation of infertility (group A) were compared with 225 women with chronic pelvic pain of greater than 6 months' duration (group B).InterventionPatient-assisted laparoscopy with intravenous conscious sedation and pelvic pain mapping.Measurements and main resultsOf women in group A, 69% had correct right-left orientation, 18% had pain perceived on the opposite side of the abdomen, and 31% had pain referred to another location in the abdomen. The results were similar in women in group B, 65% of whom had correct orientation, 15% had pain perceived on the opposite side of the abdomen, and 35% had pain referred to another location.ConclusionThis demonstrates the need to ask on which side a woman feels pain during physical examination. It is not correct to assume that an answer of "yes" means the same side of the pelvis that is being examined. Patient-assisted laparoscopy and pelvic pain mapping are excellent in correlating the symptom with the pathology.

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