title: Pelvic floor tenderness in the etiology of superficial dyspareunia.
abstract: OBJECTIVE
  To calculate the prevalence of pelvic floor tenderness in the population of women with pelvic pain and to determine its implications for symptoms of pelvic pain.
  
  
  METHODS
  We conducted a retrospective review of patients with pelvic pain at a tertiary referral centre. Pelvic floor tenderness was defined as levator ani tenderness on at least one side during single digit pelvic examination. The prevalence of pelvic floor tenderness in this cohort of women with pelvic pain was compared with the prevalence in a cohort of women without pain attending a gynaecology clinic. In the women with pelvic pain, multiple regression was performed to determine which variables were independently associated with pelvic floor tenderness.
  
  
  RESULTS
  The prevalence of pelvic floor tenderness was 40% (75/189) in the cohort with pelvic pain, significantly greater than the prevalence of 13% (4/32) in the cohort without pain (OR 4.61; 95% CI 1.55 to 13.7, P = 0.005). On multiple logistic regression, superficial dyspareunia (OR 4.45; 95% CI 1.86 to 10.7, P = 0.001), abdominal wall pain (OR 4.04; 95% CI 1.44 to 11.3, P = 0.005), and bladder base tenderness (OR 4.65; 95% CI 1.87 to 11.6, P = 0.001) were independently associated with pelvic floor tenderness. Pelvic floor tenderness was similarly present in women with or without underlying endometriosis.
  
  
  CONCLUSIONS
  Pelvic floor tenderness is common in women with pelvic pain, with or without endometriosis, and is a contributor to superficial dyspareunia. Pelvic floor tenderness was also associated with abdominal wall pain and bladder base tenderness, suggesting that nervous system sensitization is involved in the etiology of pelvic floor tenderness.
authors.affiliation: Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC; BC Women's Centre for Pelvic Pain and Endometriosis, Vancouver BC.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Yong
authors.affiliation: Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC; BC Women's Centre for Pelvic Pain and Endometriosis, Vancouver BC.
authors.forename: Justin
authors.initials: J
authors.lastname: Mui
authors.affiliation: Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC; BC Women's Centre for Pelvic Pain and Endometriosis, Vancouver BC.
authors.forename: Catherine
authors.initials: C
authors.lastname: Allaire
authors.affiliation: Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC; BC Women's Centre for Pelvic Pain and Endometriosis, Vancouver BC.
authors.forename: Christina
authors.initials: C
authors.lastname: Williams
mesh_terms: D000328:Adult; D004414:Dyspareunia / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000503:physiopathology*; D017699:Pelvic Pain / Q000503:physiopathology*; D012189:Retrospective Studies
keywords: dyspareunia; endometriosis; pelvic floor; pelvic pain