Data-driven diagnosis and clinical presentation of high-tone pelvic floor dysfunction

Area of Science:

• Pelvic Health
• Chronic Pain Management
• Female Reproductive Health

Background:

• High tone pelvic floor dysfunction (HTPFD) is prevalent in women with pelvic pain, but lacks standardized diagnostic criteria and assessment strategies.
• Limited primary data exists on HTPFD's clinical presentation, with current literature relying on expert opinion over patient-reported data.
• Lack of consensus hinders accurate identification and effective treatment evaluation for HTPFD.

Purpose of the Study:

• To establish a pelvic myofascial tenderness score correlating with patient-reported pain reproduction.
• To compare the clinical presentation of patients with and without HTPFD.

Main Methods:

• A cross-sectional study involved 612 patients at a chronic pelvic pain center.
• Patients completed questionnaires and underwent physical exams, including palpation of six pelvic muscle sites.
• Receiver operating characteristic (ROC) curve analyses identified the diagnostic tenderness score, followed by comparative analyses of clinical presentations.

Main Results:

• A summative tenderness score of >12/60 accurately identified HTPFD (sensitivity 82.3%, specificity 79.1%).
• Patients with HTPFD (63.6%) reported more persistent pain, exacerbation with physical activity, and radiating pain.
• HTPFD significantly correlated with dyspareunia, worse sexual function, and pain-related avoidance of intercourse.

Conclusions:

• A pelvic floor muscle tenderness score >12/60 suggests HTPFD.
• HTPFD is associated with persistent, activity-exacerbated pain that may radiate and significantly impacts sexual function.
• Dyspareunia and impaired sexual function are key indicators of HTPFD.