The Australian & New Zealand journal of obstetrics & gynaecology
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Aust N Z J Obstet Gynaecol · Aug 1996
Severe chronic pelvic pain in women may be caused by ligamentous laxity in the posterior fornix of the vagina.
The aim was to prospectively study the relationship between pelvic pain of otherwise unknown origin and laxity in the posterior vaginal fornix. Twenty-eight patients with negative laparoscopy findings, lower abdominal pain and laxity in the posterior ligamentous supports of the uterus underwent surgical approximation of their uterosacral ligaments. ⋯ However, the results suggest that this may be a T12-L1 parasympathetic pain referred to the lower abdomen, perhaps due to the force of gravity stimulating pain nerves unable to be supported by the lax uterosacral ligaments in which they are contained. It was concluded that laxity in the posterior ligaments of the vagina should first be excluded before referring patients with pelvic floor discomfort or pain for psychiatric care.