Prevalência de dor neuropática em mulheres com dor pélvica crônica: revisão sistemática

Nogueira-Neto, João; Camapum, Luiz Fernando Carvalho; Lira, Lyrian Lorena Freire; Camapum, Dara Maria Sá Rêgo; Gomes, Lyvia Maria Rodrigues de Sousa; Leal, Plínio da Cunha

doi:10.63231/2595-0118.202675-en

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REVIEW ARTICLE • BrJP 9 • 2026 • https://doi.org/10.63231/2595-0118.202675-en linkcopiar

Prevalência de dor neuropática em mulheres com dor pélvica crônica: revisão sistemática

Autoria SCIMAGO INSTITUTIONS RANKINGS

JUSTIFICATIVA E OBJETIVOS A dor pélvica crônica (DPC) em mulheres é uma condição multifatorial frequentemente associada a mecanismos neuropáticos, porém a prevalência de dor neuropática (DN) nessa população permanece incerta. O objetivo deste estudo foi quantificar sistematicamente a prevalência de DN em mulheres diagnosticadas com DPC, utilizando ferramentas de triagem validadas.

CONTENTS O estudo seguiu as diretrizes Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) e foi registrada no Prospective International Registry of Systematic Reviews (PROSPERO) ID nº CRD42024593980. A busca por artigos foi realizada nas plataformas CINAHL (Cumulative Index to Nursing and Allied Health Literature), Embase, Pubmed, Scielo, SportDiscus, Web of Science, e Google Acadêmico e abrangeu estudos publicados entre 2010 e 2024. Os oito estudos incluíram 989 mulheres com DPC e relataram prevalência significativa de DN, variando de 13,6% a 66,0%. As estimativas de prevalência variaram dependendo do instrumento utilizado: 31,0% a 64,8% (S-LANSS), 35,0% a 66,0% (DN4) e 13,6% a 31,7% (painDETECT). As prevalências médias ponderadas pelo tamanho da amostra foram de 45,9% para S-LANSS, 44,3% para DN4 e 28,8% para painDETECT. DN na DPC também foi associada a menor qualidade de vida, maior sofrimento psicológico, alterações cognitivas, endometriose, vestibulodínia provocada, vulvodínia e maior intensidade da dor geniturinária.

CONCLUSÃO A DN é altamente prevalente em mulheres com DPC, o que reforça a importância da triagem de rotina para seu componente neuropático na prática clínica. É necessário realizar mais pesquisas, dado o número limitado de estudos que abordam essa relação de forma abrangente.

Descritores:
Dor crônica; Dor neuropática; Dor pélvica; Neuralgia

Authors	Year	Type of study	Location	Objectives
Whitaker et al.⁷	2014	Exploratory Prospective Cohort	United Kingdom	To determine whether women with CPP have a NP component to their pain symptoms, and how this can best be assessed. To assess the correlation between different NP questionnaires in women with CPP. To determine the acceptability of the different questionnaires in patients with CPP.
Coxon et al.⁸	2023	Exploratory Prospective Cohort	United Kingdom, United States of America, Portugal	To evaluate sensory phenotypes in women with CPP using QST developed by DFNS.
Itza et al.¹³	2012	Case-control study	Spain	To validate the turns-amplitude analysis as a diagnostic test for pelvic floor myofascial syndrome in patients with CPP. To evaluate whether the diagnostic test can identify neuropathic features in patients with CPP.
George et al.¹⁴	2012	Exploratory Prospective Cohort	United States of America	To assess the quality of life of patients with CPP in relation to the presence of neuropathic symptoms.
Tersiguel et al.¹⁵	2021	Cross‑sectional study	France	To investigate the presence of a neuropathic component in the pathogenesis of vulvodynia in women with CPP. To determine the presence of anxiety, depression and other chronic pain conditions in patients with vulvodynia.
Dargie et al.¹⁶	2017	Cross-sectional study	Online research without geographical restrictions	To identify self-reported NP characteristics in women with provoked vulvar pain using the S-LANSS, NPSI and PQAS questionnaires.
Bouko-Levy et al.¹⁷	2024	Retrospective Cohort	France	Examine the prevalence of neuropathic pain in women with symptomatic endometriosis, and explore the factors associated with this type of pain.
Schrepf et al.¹⁸	2022	Multicenter retrospective cross‑sectional study	MAPP research network	Evaluate whether UCPPS is a predominantly nociceptive condition, and which pain mechanisms contribute to this condition.

Authors	Sample	Age (years) Mean±SD [Range]	Questionnaires			Conclusions
Authors	Sample	Age (years) Mean±SD [Range]	S-LANSS	DN4	PainDETECT	Conclusions
Whitaker et al.⁷	72	34.00±8.85 [20-54]	56.0%	35.0%	26.0%	NP is an important component of CPP, regardless of associated pelvic disease. The agreement between questionnaires was moderate, suggesting that multiple instruments may be necessary for a comprehensive assessment. The painDETECT and S-LANSS questionnaires were rated as favorable in 93% and 89% of patients, respectively, demonstrating high acceptability.
Coxon et al.⁸	59	35.57 [20-51]	-	-	13.6%	There are significant changes in somatosensory function in women with CPP, with 6.8% of patients presenting a healthy sensory profile (sensation similar to that of the pain-free population).
Itza et al.¹³	32	45.69±14.65 [NR]	-	56.7%	-	The study demonstrated that the range of rotation test is reliable for diagnosing pelvic floor myofascial pain syndrome. Based on the data obtained by the questionnaire, there is a higher prevalence of NP in women with CPP.
George et al.¹⁴	132	45.00 [14-82]	31.0%	-	-	Patients with CPP and neuropathic symptoms report worse quality of life compared to the general population.
Tersiguel et al.¹⁵	15	44.00 [20-74]	-	66.0%	-	From DN4 onwards, 66% of patients with vulvodynia presented a neuropathic component, i.e., neuropathy plays an important role in the pathogenesis of vulvodynia. There is a higher prevalence of psychological distress experienced by patients with CPP and NP.
Dargie et al.¹⁶	65	36.46±13.79 [NR]	64.8%	-	-	A significant proportion of women with provoked vulvar pain had features of NP, suggesting a significant neuropathic component in this condition.
Bouko-Levy et al.¹⁷	236	32.6±7.76 [NR]	-	44.1%	-	Younger age, being in a relationship, having a high EPH-5 score and undergoing laparoscopy for endometriosis are associated with neuropathic pain independently of other variables.
Schrepf et al.¹⁸	378	44.87±15.68 [NR]	-	-	31.7%	Neuropathic pain was associated with genital pain and/or sensitivity on pelvic exam, while nociplastic pain was associated with comorbid pain conditions, psychosocial difficulties, and increased pressure pain sensitivity outside the pelvis.

Questions	Whitaker et al. ⁷	Coxon et al. ⁸	Itza et al. ¹³	George et al. ¹⁴	Tersiguel et al. ¹⁵	Dargie et al. ¹⁶	Bouko-Levy et al. ¹⁷	Schrepf et al. ¹⁸
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[1] CPP = Chronic Pelvic Pain; NP = Neuropathic Pain; QST = Quantitative Sensory Testing; DFNS = German Research Network on Neuropathic Pain; S-LANSS = Self-Report Leeds Assessment of Neuropathic Symptoms and Signs; NPSI = Neuropathic Pain Symptom Inventory; PQAS = Pain Quality Assessment Scale; MAPP = Multidisciplinary Approach to the Study of Chronic Pelvic Pain; UCPPS = Urologic Chronic Pelvic Pain Syndrome.