Clinical outcome in female patients with pelvic pain and normal pelvic US findings

PURPOSE: To understand the clinical outcome in patients with pelvic pain an d negative pelvic ultrasonographic (US) findings. MATERIALS AND METHODS: Data from 86 female patients with pelvic pain and no rmal pelvic US findings seen in a US section over a 15-month period were ev aluated 6-21 months after US. Medical chart review follow-up was available in 86 patients, and telephone interview follow-up was conducted in 85 patie nts, We collected data on the outcome of pain; subsequent imaging, treatmen t, and surgery; and the duration of pain before US. RESULTS: Pelvic pain improved or resolved in 66 (77%) of the 86 patients. I n the group with acute or subacute pain (duration less than or equal to 6 m onths), 62 (86%) of the 72 patients (19 with acute pain and 53 with subacut e pain) had improvement or resolution of symptoms. In the group with chroni c pain (duration > 6 months), seven (50%) of the 14 patients had improved s ymptoms. Further imaging (13 studies) was performed in nine patients: Twelv e studies were normal, and one computed tomographic scan (1 month after the first US examination) showed diverticulitis, Eleven patients underwent 19 surgical procedures (endometrial sampling, hysteroscopy, laparoscopy, or hy sterectomy). Four demonstrated clinically important disease (endometriosis and pelvic varices, endometriosis, adenomyosis, or pelvic adhesions). CONCLUSION: The majority of patients with pelvic pain and normal pelvic US findings had improvement or resolution of their symptoms, and those with ac ute or subacute pain were more likely to report improvement or resolution o f pain than those with chronic pain. The yield of further imaging studies w as low, and disease was identified in a minority of patients.