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Diagnóstico basado en datos y presentación clínica de la disfunción del suelo pélvico de tono alto

Sara R Till¹, Andrew Schrepf², Anne Arewasikporn²

¹Department of Obstetrics and Gynecology, University of Michigan, 1500 E. Medical Center Dr. Ann Arbor, MI 48109.

American journal of obstetrics and gynecology

|December 19, 2025

Resumen

La disfunción del suelo pélvico de tono alto (HTPFD) se diagnostica con una puntuación de sensibilidad de >12/60. La HTPFD se relaciona con dolor pélvico persistente, exacerbado por la actividad y caracterizado por relaciones sexuales dolorosas y alteración de la función sexual.

Área de la Ciencia:

Salud Pélvica
Manejo del Dolor Crónico
Salud Reproductiva Femenina

Sus antecedentes:

La disfunción del suelo pélvico de tono alto (HTPFD) es prevalente en mujeres con dolor pélvico, pero carece de criterios diagnósticos estandarizados y estrategias de evaluación.
Existen datos primarios limitados sobre la presentación clínica de la HTPFD, y la literatura actual se basa en la opinión de expertos en lugar de datos informados por el paciente.
La falta de consenso dificulta la identificación precisa y la evaluación del tratamiento eficaz para la HTPFD.

Objetivo del estudio:

Establecer una puntuación de sensibilidad miofascial pélvica que se correlacione con la reproducción del dolor informada por el paciente.
Comparar la presentación clínica de pacientes con y sin HTPFD.

Principales métodos:

Un estudio transversal involucró a 612 pacientes en un centro de dolor pélvico crónico.
Los pacientes completaron cuestionarios y se sometieron a exámenes físicos, incluida la palpación de seis sitios musculares pélvicos.
Los análisis de la curva característica operativa del receptor (ROC) identificaron la puntuación de sensibilidad diagnóstica, seguidos de análisis comparativos de las presentaciones clínicas.

Principales resultados:

Una puntuación de sensibilidad sumatoria de >12/60 identificó con precisión la HTPFD (sensibilidad 82,3%, especificidad 79,1%).
El 63,6% de los pacientes con HTPFD informaron dolor más persistente, exacerbación con la actividad física y dolor irradiado.
La HTPFD se correlacionó significativamente con la dispareunia, una peor función sexual y la evitación de las relaciones sexuales relacionada con el dolor.

Conclusiones:

Una puntuación de sensibilidad del suelo pélvico de >12/60 sugiere HTPFD.
La HTPFD se asocia con dolor persistente y exacerbado por la actividad que puede irradiarse y afecta significativamente la función sexual.
La dispareunia y la alteración de la función sexual son indicadores clave de HTPFD.

Palabras clave:

dolor pélvico crónico dispareunia disfunción sexual femenina síndrome del elevador del ano disfunción del suelo pélvico miofascial dolor nociplástico sensibilidad del suelo pélvico dolor miofascial pélvico

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