Clinical Spectrum and Diagnostic Correlates of Chronic Pelvic Pain Among Women: A Prospective Study in a Tertiary Care Center

Background: Chronic pelvic pain (CPP) in women is a common yet often underdiagnosed condition with multifactorial etiologies, impacting quality of life, daily functioning, and reproductive health. This prospective observational study aims to evaluate the clinical presentation, associated factors, and diagnostic findings in females presenting with CPP at a tertiary care center in Patna. Objectives: To assess the clinical profile, possible etiologies, and diagnostic outcomes of chronic pelvic pain in women attending the gynecology outpatient department. Methods: A prospective observational study was conducted over a period of 12 months in the Department of Obstetrics and Gynaecology at Patna Medical College and Hospital. A total of 130 women aged between 18 and 45 years, presenting with pelvic pain persisting for more than six months, were enrolled after obtaining informed consent. Detailed clinical history, physical and pelvic examination, laboratory investigations, transvaginal sonography (TVS), and laparoscopy (when indicated) were performed to identify the underlying cause of pain. Results: Out of 130 participants, the most common complaints included dull aching lower abdominal pain (76.2%), dyspareunia (42.3%), and dysmenorrhea (39.2%). Gynecological causes were identified in 61.5% of cases, including pelvic inflammatory disease (28.5%), endometriosis (15.4%), and adnexal masses (10%). Nongynecological causes such as urinary tract infection (13.1%) and irritable bowel syndrome (7.7%) were also noted. In 17.7% of patients, no definitive cause could be established despite thorough evaluation. Laparoscopy provided definitive diagnosis in 26.2% of cases, especially for conditions like endometriosis and pelvic adhesions not detected by routine imaging. Conclusion: Chronic pelvic pain in females is a complex clinical condition with diverse etiologies, predominantly of gynecological origin. A structured approach including detailed history, examination, imaging, and diagnostic laparoscopy can significantly aid in identifying the cause and guiding management. Increased awareness and timely intervention are essential to reduce the burden and improve quality of life in affected women