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Abstract Background The evaluation of chronic pelvic and perineal pain (CPP) is often complex. The patient’s description of the pain often appears to be disproportionate to the limited findings on physical examination and/or complementary investigations. The concept of central sensitization may allow better understanding and management of patients with CPP. Objective The aim of this study was to elaborate a clinical evaluation tool designed to simply identify sensitization in pelvic pain. Methods A list of 63 items was submitted to 22 international CPP experts according to the Delphi method. Results Ten clinical criteria were adopted for the creation of a clinical evaluation tool: 1) pain influenced by bladder filling and/or urination, 2) pain influenced by rectal distension and/or defecation, 3) pain during sexual activity, 4) perineal and/or vulvar pain in response to normally nonpainful stimulation, 5) pelvic trigger points (e.g., in the piriformis, obturator internus, and/or levator ani muscles), 6) pain after urination, 7) pain after defecation, 8) pain after sexual activity, 9) variable (fluctuating) pain intensity and/or variable pain distribution, 10) migraine or tension headaches and/or fibromyalgia and/or chronic fatigue syndrome and/or post-traumatic stress disorder and/or restless legs syndrome and/or temporomandibular joint dysfunction and/or multiple chemical sensitivity. Conclusions  This process resulted in the elaboration of a clinical evaluation tool designed to identify and appropriately manage patients with CPP comprising a sensitization component.

Chronic pelvic pain (CPP) is chronic or persistent pain perceived in structures related to the pelvis of men and women. These individuals may suffer significant distress and detriment to their daily living and quality of life. Neuromodulation may provide an effective treatment option in patients with CPP refractory to standard treatment, reducing pain and improving quality of life with an acceptable rate of complications. However, study quality is insufficient for a more certain conclusion, and therefore larger-scale, well-designed, and powered randomized controlled trials with long-term outcomes are needed.

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