Intensity of menstrual pain and estimated angle of uterine flexion. (3rd December 2013)

• Record Type: Journal Article
• Authors: Cagnacci, Angelo; Grandi, Giovanni; Cannoletta, Marianna; Xholli, Anjeza; Piacenti, Ilaria; Volpe, Annibale
• Is Part Of: Acta obstetricia et gynecologica Scandinavica. Volume 93:Number 1(2014)
• Page Start: 58
• Page End: 63
• Publication Date: 2013-12-03
• Subjects: Gynecology -- Periodicals; Pregnancy -- Periodicals; Obstetrics -- Periodicals; 618.05
• DOI: 10.1111/aogs.12266
• Languages: English
• ISSNs: 0001-6349

Abstract

<abstract abstract-type="main" id="aogs12266-abs-0001"> <title>Abstract</title> <sec id="aogs12266-sec-0001" sec-type="section"> <title>Objective</title> <p>To assess the impact of ultrasound‐estimated uterus position on the intensity of pelvic pain.</p> </sec> <sec id="aogs12266-sec-0002" sec-type="section"> <title>Design</title> <p>Descriptive analytical study.</p> </sec> <sec id="aogs12266-sec-0003" sec-type="section"> <title>Setting</title> <p>Tertiary university gynecology unit.</p> </sec> <sec id="aogs12266-sec-0004" sec-type="section"> <title>Population</title> <p>181 consecutive patients with pelvic pain.</p> </sec> <sec id="aogs12266-sec-0005" sec-type="section"> <title>Methods</title> <p>Each woman underwent physical examination, transvaginal sonography and filled self‐administered questionnaires on pain using a 10‐cm visual analog scale (VAS).</p> </sec> <sec id="aogs12266-sec-0006" sec-type="section"> <title>Main outcome measures</title> <p>Visual analog scale score of menstrual pain, intermenstrual pain and dyspareunia was related to uterine version (ante‐ or retroversion) and the angle of uterine flexion (actual angle between cervix and uterine body) evaluated by transvaginal sonography.</p> </sec> <sec id="aogs12266-sec-0007" sec-type="section"> <title>Results</title> <p>Estimated uterine version was not associated with the intensity of any type of pain. The estimated angle of flexion was higher in retroverted than in anteverted uteri (182.3° ± 50.3° vs. 142.3° ± 24.2°, <italic>p </italic>< 0.0001). Intensity of menstrual pain was lowest with flexion between 150° and 210° (4.9 ± 3.1) (<italic>p </italic>= 0.002), intermediate with flexion <150° (6.3 ± 2.8) and highest with flexion ≥210° (7.9 ± 2.3). Severe menstrual pain was more prevalent with flexion ≥210° (77.7%) than between 150° and 210° (31.4%; <italic>p</italic> = 0.0008) or <150° (45.2%; <italic>p</italic> = 0.005). The intensity of intermenstrual pain and dyspareunia were not associated with the angle of flexion. In multiple regression analysis, the angle of flexion was independently related only to the intensity of menstrual pain (<italic>r</italic> = 0.272; <italic>p </italic>= 0.002).</p> </sec> <sec id="aogs12266-sec-0008" sec-type="section"> <title>Conclusions</title> <p>In women with pelvic pain, ultrasound‐estimated uterine flexion represents an independent risk for intense menstrual pain.</p> </sec> </abstract>