School of Clinical Medicine, UNSW Medicine & Health, Discipline of Obstetrics and Gynaecology, Level 1, Royal Hospital for Women, Barker Street, Randwick, Sydney, NSW, 2031, Australia.
Department of O&G, Westmead Hospital, Sydney, Australia.
Int Urogynecol J. 2022 Sep;33(9):2379-2389. doi: 10.1007/s00192-022-05258-7. Epub 2022 Jul 7.
Myofascial pain arising from pelvic floor muscles occurs in women with vaginismus, interstitial cystitis and endometriosis but is often overlooked. The aim is to examine alternative diagnostic tests to detect pelvic floor myofascial pain compared with standardized vaginal palpation of pelvic floor muscles as the reference test.
A systematic review was prospectively conducted (PROSPERO-CRD42020183092) according to PRISMA guidelines. Databases searched included Ovid Medline 1946-, Embase 1957-, Scopus 1960-, Cochrane Combined, Clinical trials, Google Scholar (top 200 articles), Web of Science, TRIP, BIOSIS, DARE, CINHAL, EmCare, PEDro, ProQuest and EBSCOhost up to July 2020. Articles were independently screened by two authors and assessed for bias using QUASDAS-2 tool.
A total of 26,778 articles were screened and 177 were selected for full text review, of which 5 were selected for final analysis. Five studies included 9694 participants of which 1628 had pelvic floor myofascial pain. Only one study reported data to calculate sensitivities and specificities of the index test, which utilized a score of > 40 on the Central Sensitization Inventory to detect women with pelvic floor myofascial pain and revealed a sensitivity of 34.8% and a specificity of 84.9% compared to the reference test.
This systematic review did not reveal any diagnostic test superior to the pre-defined reference test. There is a lack of consensus on the definition of pelvic floor myofascial pain and a lack of a validated diagnostic criteria which must be addressed to progress with meaningful research in this field.
盆腔肌肉的肌筋膜疼痛发生在患有阴道痉挛、间质性膀胱炎和子宫内膜异位症的女性中，但常常被忽视。目的是检查替代的诊断测试，以检测与标准阴道触诊盆腔肌肉相比，检测盆底肌筋膜疼痛。
根据 PRISMA 指南，前瞻性进行系统评价（PROSPERO-CRD42020183092）。搜索的数据库包括 Ovid Medline 1946-、Embase 1957-、Scopus 1960-、Cochrane 联合、临床试验、Google Scholar（前 200 篇文章）、Web of Science、TRIP、BIOSIS、DARE、CINHAL、EmCare、PEDro、ProQuest 和 EBSCOhost，截至 2020 年 7 月。两名作者独立筛选文章，并使用 QUASDAS-2 工具评估偏倚。
共筛选出 26778 篇文章，有 177 篇文章进行了全文审查，其中 5 篇文章被选中进行最终分析。五项研究纳入了 9694 名参与者，其中 1628 名患有盆底肌筋膜疼痛。只有一项研究报告了计算指标测试敏感性和特异性的数据，该研究利用中央敏化量表（Central Sensitization Inventory）上的得分>40 来检测患有盆底肌筋膜疼痛的女性，与参考测试相比，敏感性为 34.8%，特异性为 84.9%。
本系统评价未发现任何优于预定义参考测试的诊断测试。对于盆底肌筋膜疼痛的定义以及缺乏经过验证的诊断标准，目前尚未达成共识，这必须得到解决，才能在该领域进行有意义的研究。
