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Updated: May 16, 2026
Demonstration of Cutaneous Allodynia in Association with Chronic Pelvic Pain
Published on: June 23, 2009
Cotton-tipped applicator test: validity and reliability in chronic pelvic pain
Maryam Nasr-Esfahani1, John Jarrell
1Department of Obstetrics and Gynecology, Foothills Medical Center, University of Calgary, Calgary, Alberta, Canada. Maryam.nasr-esfahani@albertahealthservices.ca
Objective:
We sought to assess the concurrent validity and interrater reliability of the cotton-tipped applicator (CTA) test as a screening tool for diagnosis of cutaneous allodynia in patients with viscerally related chronic pelvic pain (CPP).
Study Design:
We performed a prospective cohort comparative observational study of referred patients to a gynecology clinic with CPP. A total of 22 females with CPP were compared to 23 pain-free controls and 12 cyclic pain patients. Participants were evaluated by 2 clinicians. The CTA test was performed to detect the appearance of pain in dermatomes of T10-L1.
Results:
Interrater reliability resulted in 98% agreement for the 3 study groups. CTA test showed 73% sensitivity and 100% specificity for differentiating patients with CPP from pain-free patients.
Conclusion:
The CTA test had excellent interrater reliability and concurrent validity for diagnosis of cutaneous allodynia in CPP patients with visceral diseases versus controls.
