Sexual abuse and chronic pelvic pain in a gynecology outpatient clinic. A pilot study

Int Urogynecol J. 2021 May;32(5):1285-1291. doi: 10.1007/s00192-021-04772-4. Epub 2021 Mar 30.

Abstract

Introduction and hypothesis: Almost 20% of women will suffer from sexual abuse at some point in their lives. This is a known risk factor for developing chronic pelvic pain (CPP), which is a major health problem worldwide. We conducted a pilot study in a Gynecology Outpatient Clinic to find the correlation between these two clinical entities and provide better evidence for their diagnosis and treatment.

Methods: A semi-structured interview for the evaluation of sexual violence in women (EVS) was used as a screening tool and a complement to routine gynecological examination to identify patients suffering from sexual abuse. Patients included were also assessed for comorbidities, including CPP, and other coexisting mental health problems.

Results: Of the 61 patients screened, 33 (54.1%) had pelvic pain. Also, 11 patients (18%) had suffered sexual abuse at some point in their lives, which was only disclosed when the specific interview was performed. Ten patients (90.8%) out of 11 that had been sexually abused also had pelvic pain. This was found to be statistically significant in this sample (p = 0.008) with a more than 11-fold greater risk of having pelvic pain (OR, 11.7; 95% CI, 1.4-98.7). Most patients did not have psychological violence (77%) but those that did (23%) had a seven-fold greater risk of having pelvic pain (OR, 7.4; 95% CI, 1.5-36.9).

Conclusion: Specific tools should intentionally be used for evaluating sexual abuse and chronic pelvic pain, since a strong correlation exists between these two entities and they are seldom reported by patients.

Keywords: Chronic pelvic pain; Psychological abuse; Sexual abuse; Violence; Women’s health.

MeSH terms

  • Ambulatory Care Facilities
  • Female
  • Gynecology*
  • Humans
  • Pelvic Pain
  • Pilot Projects
  • Sex Offenses*
  • Surveys and Questionnaires