Abdominal Wall Pain in Women With Chronic Pelvic Pain

OBJECTIVE: To investigate the role of abdominal wall pain (AWP) in women with pelvic pain. METHODS: We conducted a retrospective review of consecutive patients with pelvic pain seen in a tertiary referral centre between January and December 2012. AWP was defined as abdominal wall tenderness with a positive Carnett test (i.e., tenderness that worsened or remained the same with abdominal wall contraction). Pairwise comparisons were carried out between clinical variables (e.g., chronic pelvic pain) and AWP. This was followed by multiple logistic regression to identify the clinical variables with an independent association with AWP. RESULTS: The prevalence of AWP in women with pelvic pain was 67% (127/190). On multiple logistic regression, AWP was independently associated with chronic pelvic pain (OR 13.8; 95% CI 3.71 to 51.2, P < 0.001), but not with other symptoms including dysmenorrhea, deep and superficial dyspareunia, or bowel and bladder symptomology. In a corollary analysis, women with AWP were more likely to require opioids or pain adjuvants than women without AWP (P = 0.015 and P < 0.001). CONCLUSION: AWP is common in women with pelvic pain and may contribute specifically to the symptom of chronic pelvic pain.