Ultrasonographic Findings in Reproductive-Age Women With Chronic Pelvic Pain A Descriptive Cross-Sectional Study From Benghazi, Libya

Abstract

Abstract

Chronic pelvic pain (CPP) is a common and multifactorial condition in women of reproductive age. Ultrasound is commonly used early in the diagnostic assessment because it is accessible, non-invasive, and able to evaluate gynecological and selected non-gynecological causes of pain. This study aimed to describe the clinical characteristics and ultrasonographic findings among Libyan women presenting with CPP in Benghazi City. A descriptive cross-sectional study was conducted at Elkeish Polyclinic, Benghazi, Libya, between January and December 2018. The study included 100 Libyan women aged 15-45 years who presented with CPP. Data were collected using a structured questionnaire covering demographic characteristics, menstrual and obstetric history, pain characteristics, associated symptoms, previous imaging, and medication use. Participants underwent pelvic ultrasound using transabdominal and/or transvaginal approaches. Data were summarized using frequencies, percentages, means, medians, and standard deviations. The mean age was 30.95 ± 9.28 years. Most participants were married (61%) and housewives (51%). Dysmenorrhea was reported by 58%, and most women reported moderate pain intensity (72%). Pain duration was exactly 6 months in 35%, more than 6 months but less than 12 months in 46%, and more than 12 months in 19%. Ultrasound findings were normal in 38%. The most frequent individual abnormal findings were chronic cystitis with bladder wall thickening (6%), free fluid in the pouch of Douglas (6%), right ovarian cystic lesion (5%), polycystic ovarian morphology (4%), left hydronephrosis (4%), right hydronephrosis (4%), and multiple uterine fibroids (3%). Less frequent findings included subserosal or submucosal fibroids, dermoid cyst, endometrial cystic changes, suspected renal stone, ectopic kidney, appendicitis, and pregnancy-associated findings. In this single-center Libyan sample, CPP was associated with heterogeneous clinical presentations and a high proportion of normal ultrasound examinations. When abnormal, ultrasound findings involved urinary, gynecological, adnexal, and incidental abdominal abnormalities. Pelvic ultrasound remains a useful initial imaging tool; however, a normal scan should prompt continued multidisciplinary assessment when CPP persists.

Keywords: CHRONIC PELVIC PAIN, ULTRASOUND, TRANSVAGINAL SONOGRAPHY, REPRODUCTIVE AGE, GYNECOLOGY, LIBYA