High Rate of Pelvic Pain in Women Who See Urologist for Reasons Unrelated to Pain

By Linda Carroll

July 23, 2020

(Reuters Health) - Four in 10 women who seek care from urologists for reasons unrelated to pain may also be suffering from pelvic pain, a new study suggests.

The survey of 181 female patients who had come to see a urologist for a non-pain related issue found that many women experienced pain severe enough to inhibit their normal activities, according to the report published in Urology.

"The high prevalence of pelvic pain in patients presenting for an unrelated chief complaint suggests that, similar to other urologic disorders such as urinary incontinence, providers should actively solicit information about pelvic pain during routine evaluation," writes the study team led by Dr. David Rapp, an associate professor of urology at the University of Virginia School of Medicine, in Charlottesville. "Indeed, given the hesitancy of women to discuss disorders like urinary incontinence, the routine assessment for urinary incontinence is included as a quality metric by the Centers for Medicare and Medicaid Services."

To take a closer look at the prevalence and types of pelvic pain in their female patients, the researchers conducted a prospective, survey-based assessment of patients presenting to a urology clinic at a single tertiary care center over a 10-month period. The women were recruited by a study coordinator during clinic registration. Patients who had come to the clinic because of a pain issue, such as interstitial cystitis, were excluded from the study.

Each patient was given a 22-item survey to complete, with questions on demographics, relevant past medical history and pelvic pain symptoms, such as the type, location and intensity of the pain.

Of the 181 patients, 75, or 41%, said they had experienced pelvic pain. Two thirds of those women reported experiencing the pain "often," "usually" or "always" over the preceding month. Patients experiencing pelvic pain tended to be younger, 52 versus 59, and had a higher BMI compared to those without pain.

The most common sites of pain were the lower back, 73%, and the bladder, 72%. A majority of patients reported multiple concurrent pain locations.

The most common type of pain was "sharp/stabbing," reported by 55% of women. Most patients reported that their pelvic pain was severe, frequent and quality of life limiting. Eighty-three percent reported that their pelvic pain inhibited their normal activities.

The new study is a reminder that urologists should be asking their female patients about pelvic pain, said Dr. Marisa Clifton, an assistant professor and urology residency director at the Johns Hopkins School of Medicine in Baltimore. "The field is so male focused," Dr. Clifton said. "We have to acknowledge that women have quality of life issues related to pelvic pain. We could be greatly impacting our patients' lives."

Dr. Clifton was surprised at the percentage of women who said their pelvic pain interfered with their lives. "It's something we won't know about if we don't ask. It's pretty eye opening to see that more than 40% of patients have pelvic pain often, usually or always. And 83% of them said the pain inhibited their normal activity. That's crazy," she said.

"For a long time, the focus (in urology) has been on men and men's sexual health," Dr. Clifton added. "This paper is a huge step in the right direction."

Dr. Rapp was not available to comment on the study.

SOURCE: https://bit.ly/30xvqDk Urology, online July 11, 2020.