Transvaginal ultrasound findings in women with chronic pelvic pain

Objective: To determine the prevalence of anatomic abnormalities as diagnosed by transvaginal ultrasonography in women with chronic pelvic pain whose pelvic examination did not demonstrate an anatomic abnormality. Methods: Transvaginal ultrasonography was performed in premenopausal women who were diagnosed with chronic pelvic pain, had a speculum and bimanual pelvic examination that revealed no evidence of gynecologic pathology, and were subsequently referred to the gynecologic ultrasound unit for pelvic ultrasonography. Women with known chronic medical or gynecologic diseases that are associated with lower abdominal pain were excluded from the study. The overall prevalence of abnormal ultrasound findings was recorded. The abnormal findings were further categorized into uterine, adnexal, and other. Results: Ultrasonography was performed on 50 women who met the entry criteria for the study. Four women (8%) had at least one abnormal anatomic finding demonstrated by pelvic ultrasonography. Of these four women, three had uterine pathology only and one had both uterine and adnexal pathology. The abnormal uterine findings were all either intramural or subserosal myomas. The only adnexal abnormality was a single unilocular fluid-filled ovarian cyst. Conclusions: Women with chronic pelvic pain who have no anatomic abnormalities as assessed by a routine gynecologic examination also are unlikely to have pelvic pathology when evaluated by transvaginal ultrasonography.