Question of the Week

For September 21, 2021

A 34-year-old woman reports an 8-month history of pelvic pain. She describes the pain as a constant dull throbbing sensation in her pelvis. She is unable to identify a specific region where the pain is localized. She reports no dysuria, dyschezia, dyspareunia, dysmenorrhea, or menorrhagia.

On pelvic examination, her external genitalia appear normal; bimanual examination reveals mild diffuse tenderness. No adnexal masses are palpable.

Laboratory tests — including a leukocyte count, urinalysis, tests for sexually transmitted infections, and a pregnancy test — are unremarkable.

Pelvic ultrasonography is normal.

This patient’s presentation is most typical of which one of the following diagnoses?

Vaginismus
Bladder diverticulum
Chronic pelvic pain
Endometriosis
Interstitial cystitis