Tu Frank F, As-Sanie Sawsan, Steege John F
Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, USA.
J Reprod Med. 2006 Mar;51(3):185-9.
To determine the prevalence of 2 musculoskeletal pain disorders among women presenting to a referral chronic pelvic pain clinic.
This was a retrospective, cross-sectional study of 987 women (aged 14-79) presenting for evaluation from 1993 to 2000 at a university-based gynecologic chronic pelvic pain clinic.
At the initial visit, all women completed standardized interviews and underwent a pelvic examination. Single-digit palpation of the levator ani and piriformis muscles was performed intravaginally. Among these women, 212 of 955 (22%) had tenderness of the levator ani muscles, while 128 of 943 (14%) had tenderness of the piriformis muscle (pain score > 3 of 10 on a visual analogue scale). Both levator ani tenderness and piriformis tenderness were associated with a higher total number of pain sites, previous surgery for pelvic pain, Beck Depression Inventory score, McGill Pain Inventory score and pain worsened with bowel movements (p < 0.05).
Piriformis and levator ani pain are present in a significant proportion of female chronic pelvic pain patients. Further research into the natural course, diagnosis and treatment of pelvic musculoskeletal pain is needed to determine its true contribution to chronic pain.
确定在一家慢性盆腔疼痛转诊诊所就诊的女性中两种肌肉骨骼疼痛疾病的患病率。
这是一项对1993年至2000年在一家大学妇科慢性盆腔疼痛诊所就诊评估的987名女性（年龄14 - 79岁）进行的回顾性横断面研究。
在初次就诊时，所有女性均完成了标准化访谈并接受了盆腔检查。经阴道对肛提肌和梨状肌进行单指触诊。在这些女性中，955名中有212名（22%）肛提肌有压痛，而943名中有128名（14%）梨状肌有压痛（视觉模拟评分法疼痛评分>3分（满分10分））。肛提肌压痛和梨状肌压痛均与疼痛部位总数较多、既往盆腔疼痛手术史、贝克抑郁量表评分、麦吉尔疼痛问卷评分以及排便时疼痛加重相关（p<0.05）。
相当一部分女性慢性盆腔疼痛患者存在梨状肌和肛提肌疼痛。需要对盆腔肌肉骨骼疼痛的自然病程、诊断和治疗进行进一步研究，以确定其对慢性疼痛的真正影响。
