Cervical Tenderness (Parametropathy) is a Diagnostic Tool for the Chronic Pelvic Pain Syndrome.

IF 3.3 2区医学 Q1 CLINICAL NEUROLOGY

Pain and Therapy Pub Date : 2025-10-01 Epub Date: 2025-07-10 DOI:10.1007/s40122-025-00760-4

Stefan Weinschenk, Thomas Strowitzki, Nura Fitnat Topbas Selcuki, Oliver Zivanovic, Axel Gerhardt, Manuel Feisst

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引用次数: 0

Abstract

Introduction: Chronic pelvic pain syndrome (CPPS) is a diagnosis of exclusion in the absence of pathological findings. We aimed to test the hypothesis that cervical motion tenderness (or parametropathy) may serve as a diagnostic tool for CPPS.

Methods: We examined the prevalence of parametropathy in patients with and without chronic pelvic pain by analyzing consecutive vaginal examinations in 155 women ≥ 18 years. Patients with malignant pelvic tumors, acute inflammatory disease, abnormal bleeding, genital atrophy, or pregnancy were excluded. Results from repeat examinations were also excluded. Parametropathy was defined as tenderness at three different points (left, middle, and right vaginal fornix) on bimanual examination, expressed by the patient on a three-digit scale: Pain index 0, absent; 1, slight tenderness; 2, remarkable tenderness. A pain index (PI) of 2 at one or more sites was considered positive.

Results: We included 155 first examinations, 125 for preventive screening (control group), and 30 examinations from patients with lower abdominal pain for ≥ 6 months. Parametropathy with a PI ≥ 2 in ≥ 1 site was found in 96.7% of the pain group, and in 7.2% of the control group (p < 0.001). The diagnostic value of parametropathy for chronic pelvic pain was 96.7% sensitivity and 92.8% specificity. Vaginal ultrasound probe pressure revealed a similar tenderness rate (agreement kappa 0.94-1.00), but with a lower sensitivity of 86.7% and specificity of 92.0%. The prevalence of parametropathy in both groups was higher on the left side (p = 0.03).

Conclusions: Parametropathy, defined as cervical motion tenderness, is a positive sign of chronic pelvic pain syndrome. The cervical motion test to detect parametropathy can be used both as a screening tool and to confirm suspected chronic pelvic pain syndrome. We suggest including this easy-to-perform clinical test in every gynecological examination. By doing so, chronic pelvic pain syndrome will no longer be a diagnosis of exclusion.

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宫颈压痛是慢性盆腔疼痛综合征的诊断工具。

慢性盆腔疼痛综合征（CPPS）是一种在没有病理发现的情况下的排除诊断。我们的目的是验证颈椎运动压痛（或参数性病变）可能作为CPPS的诊断工具的假设。方法：通过对155名年龄≥18岁的女性进行连续阴道检查，研究伴有和不伴有慢性盆腔疼痛的患者中参数性病变的患病率。排除盆腔恶性肿瘤、急性炎性疾病、异常出血、生殖器萎缩、妊娠等患者。重复检查的结果也被排除在外。参数性病变定义为双手检查时三个不同点（左、中、右阴道穹窿）的压痛，由患者以三位数表示：疼痛指数0，无；1、轻微的柔情；2、非凡的温柔。一个或多个部位的疼痛指数（PI）为2为阳性。结果：首次检查155例，预防性筛查125例（对照组），下腹痛≥6个月患者检查30例。96.7%的疼痛组和7.2%的对照组在≥1个部位出现PI≥2的顺性病变(p)。结论：顺性病变，定义为颈椎运动压痛，是慢性盆腔疼痛综合征的一个积极信号。宫颈运动试验可作为一种筛查工具，同时也可用于确认疑似慢性盆腔疼痛综合征。我们建议在每次妇科检查中都包括这项易于操作的临床检查。通过这样做，慢性盆腔疼痛综合征将不再是一个排除的诊断。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pain and Therapy CLINICAL NEUROLOGY-

CiteScore

6.60

自引率

5.00%

发文量

110

审稿时长

6 weeks

期刊介绍： Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.