Adaptation and Validation of the International Pelvic Pain Society's Quality of Life Questionnaire in Portuguese.

OBJECTIVE: In the present study, our aim was to translate, adapt, and validate the Pelvic Health History Form (a quality of life [QoL] questionnaire) of the International Pelvic Pain Society (IPPS) from English to Portuguese. METHODS: The study was approved by the Ethics and Research Committee (CEP, in the Portuguese acronym) and the IPPS. The "Transcultural Adaptation" method comprised 5 stages: translation, synthesis, backtranslation, expert review, and pretest. Cultural adaptation and validation included cognitive interviews and statistical analysis of unanswered items (> 15%) in 14 clinic patients from CPP and endometriosis clinic at Santa Casa de São Paulo. RESULTS: Strong equivalences were established between the USA and Brazil questionnaires in terms of semantics, idioms, experiences, and concepts. Eighteen culturally inappropriate items were identified and adjusted using the revised response rate index. The subjective form underwent rigorous assessments, confirming its accurate measurement of intended targets. CONCLUSION: The methodology showed efficiency and equivalence, confirming its validity. The user-friendly format and inclusion of translated, adapted, and validated instruments in Portuguese make the form valuable for evaluating pelvic health, with potential for future research.

OBJETIVO: Realizar a tradução, adaptação e validação do questionário de qualidade de vida Pelvic Health History Form da International Pelvic Pain Society (IPPS, na sigla em inglês) para a língua portuguesa. MéTODOS: Aprovação do Comitê de Ética e Pesquisa (CEP) e consentimento do IPPS. A metodologia "Adaptação Transcultural" foi utilizada em cinco etapas: (I) tradução; (II) síntese; (III) retradução; (IV) revisão pelo comitê de especialistas; (V) pré-teste, seguido de adaptação cultural e validação por meio de entrevista cognitiva e análise estatística da taxa de ausência de respostas > 15% após aplicação do instrumento em 14 pacientes do ambulatório de DPC e endometriose da Santa Casa de São Paulo. RESULTADOS: Equivalências semântica, idiomática, experiencial e conceitual entre o questionário de país fonte (EUA) e alvo (Brasil) foram bem estabelecidas. Dezoito itens culturalmente impróprios, de acordo com o índice de ausência de respostas revisados, adaptados e realizada validade de face e de constructo, avaliando forma subjetiva, confiável que o instrumento mede o que pretende medir. CONCLUSãO: A metodologia utilizada foi eficiente, com boa equivalência com o material de origem concluindo a sua validade. Formulário de formato simples, fácil aplicação e compreensão, composto por diversos instrumentos já traduzidos, adaptados e validados em nossa língua. O formulário auxilia avaliação multidimensional da saúde pélvica destas pacientes e poderá ser utilizado em estudos futuros.

Adaptation and Validation of the International Pelvic Pain Society's Quality of Life Questionnaire in Portuguese / Adaptação e validação do questionário de qualidade de vida da International Pelvic Pain Society em português

Abstract Objective In the present study, our aim was to translate, adapt, and validate the Pelvic Health History Form (a quality of life [QoL] questionnaire) of the International Pelvic Pain Society (IPPS) from English to Portuguese. Methods The study was approved by the Ethics and Research Committee (CEP, in the Portuguese acronym) and the IPPS. The "Transcultural Adaptation" method comprised 5 stages: translation, synthesis, backtranslation, expert review, and pretest. Cultural adaptation and validation included cognitive interviews and statistical analysis of unanswered items (> 15%) in 14 clinic patients from CPP and endometriosis clinic at Santa Casa de São Paulo. Results Strong equivalences were established between the USA and Brazil questionnaires in terms of semantics, idioms, experiences, and concepts. Eighteen culturally inappropriate items were identified and adjusted using the revised response rate index. The subjective form underwent rigorous assessments, confirming its accurate measurement of intended targets. Conclusion The methodology showed efficiency and equivalence, confirming its validity. The user-friendly format and inclusion of translated, adapted, and validated instruments in Portuguese make the form valuable for evaluating pelvic health, with potential for future research.

Resumo Objetivo Realizar a tradução, adaptação e validação do questionário de qualidade de vida Pelvic Health History Form da International Pelvic Pain Society (IPPS, na sigla em inglês) para a língua portuguesa. Métodos Aprovação do Comitê de Ética e Pesquisa (CEP) e consentimento do IPPS. A metodologia "Adaptação Transcultural" foi utilizada em cinco etapas: (I) tradução; (II) síntese; (III) retradução; (IV) revisão pelo comitê de especialistas; (V) pré-teste, seguido de adaptação cultural e validação por meio de entrevista cognitiva e análise estatística da taxa de ausência de respostas> 15% após aplicação do instrumento em 14 pacientes do ambulatório de DPC e endometriose da Santa Casa de São Paulo. Resultados Equivalências semântica, idiomática, experiencial e conceitual entre o questionário de país fonte (EUA) e alvo (Brasil) foram bem estabelecidas. Dezoito itens culturalmente impróprios, de acordo com o índice de ausência de respostas revisados, adaptados e realizada validade de face e de constructo, avaliando forma subjetiva, confiável que o instrumento mede o que pretende medir. Conclusão A metodologia utilizada foi eficiente, com boa equivalência com o material de origem concluindo a sua validade. Formulário de formato simples, fácil aplicação e compreensão, composto por diversos instrumentos já traduzidos, adaptados e validados em nossa língua. O formulário auxilia avaliação multidimensional da saúde pélvica destas pacientes e poderá ser utilizado em estudos futuros.

Misoprostol Administration Before Hysteroscopy Procedures - A Retrospective Analysis / O uso do misoprostol prévio aos procedimentos histeroscópicos - Um estudo retrospectivo

Abstract Objective To evaluate the use of misoprostol prior to hysteroscopy procedures regarding technical ease, the presence of side effects, and the occurrence of complications. Methods This is a retrospective, observational, analytical, case-control study, with the review of medical records of 266 patients followed-up at the Gynecological Videoendoscopy Sector of the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto of the Universidade de São Paulo (HCFMRP - USP, in the Portuguese acronym) from 2014 to 2019, comparing 133 patients who used the drug before the procedure with 133 patients who did not. Results The occurrence of postmenopausal uterine bleeding was the main indication for hysteroscopy and revealed a statistical difference between groups (p < 0.001), being present in 93.23% of the patients in the study group and in 69.7% of the patients in the control group. Only 2 patients (1.5%) in the study group reported adverse effects. Although no statistical differences were observed regarding the occurrence of complications during the procedure (p = 0.0662), a higher total number of complications was noted in the group that used misoprostol (n = 7; 5.26%) compared with the group that did not use the drug (n = 1; 0.75%), a fact that is clinically relevant. When evaluating the ease of the technique (measured by the complete performance of all steps of the hysteroscopy procedure), it was verified that although there was no difference between groups (p = 0.0586), the control group had more than twice as many incompletely performed procedures (n = 17) when compared with the group that used misoprostol previously (n = 8), which is also clinically relevant. Conclusion The use of misoprostol prior to hysteroscopy in our service indicated that the drug can facilitate the performance of the procedure, but not without side effects and presenting higher complication rates.

Resumo Objetivo Avaliação do misoprostol prévio à histeroscopia quanto à facilidade técnica, efeitos colaterais e a ocorrência de complicações durante o procedimento. Métodos Estudo analítico observacional retrospectivo tipo caso controle com revisão de prontuários de 266 pacientes do Setor de Videoendoscopia Ginecológica do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - Universidade de São Paulo (HCFMRP - USP), de 2014 a 2019, sendo comparadas 133 pacientes que utilizaram o medicamento prévio ao procedimento com 133 pacientes que não o utilizaram. Resultados Sangramento uterino após a menopausa foi a principal indicação de histeroscopia, apresentando diferença estatística (p < 0,001), estando presente em 93,23% das pacientes do grupo de estudo e em 69,17% das pacientes do grupo controle. Apenas 2 pacientes (1,5%) do grupo de estudo relataram efeitos adversos. Não foram observadas diferenças quanto à presença de complicações durante o procedimento (p = 0,0662), mas observamos um número total de complicações maior no grupo de estudo (n = 7; 5,26%) do que no grupo controle (n = 1; 0,75%), o que é clinicamente relevante. Não houve diferença entre os grupos quanto à facilidade técnica (p = 0,0586), mas o grupo controle apresentou mais do que o dobro de procedimentos não completamente realizados (n = 17) quando comparado com o grupo de estudo (n = 8), o que é clinicamente relevante. Conclusão O uso de misoprostol prévio à histeroscopia no nosso serviço demonstrou que ele pode facilitar a realização do procedimento, mas não é isento de efeitos colaterais e apresenta maiores taxas de complicações.

Misoprostol Administration Before Hysteroscopy Procedures - A Retrospective Analysis.

OBJECTIVE: To evaluate the use of misoprostol prior to hysteroscopy procedures regarding technical ease, the presence of side effects, and the occurrence of complications. METHODS: This is a retrospective, observational, analytical, case-control study, with the review of medical records of 266 patients followed-up at the Gynecological Videoendoscopy Sector of the Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto of the Universidade de São Paulo (HCFMRP - USP, in the Portuguese acronym) from 2014 to 2019, comparing 133 patients who used the drug before the procedure with 133 patients who did not. RESULTS: The occurrence of postmenopausal uterine bleeding was the main indication for hysteroscopy and revealed a statistical difference between groups (p < 0.001), being present in 93.23% of the patients in the study group and in 69.7% of the patients in the control group.: Only 2 patients (1.5%) in the study group reported adverse effects. Although no statistical differences were observed regarding the occurrence of complications during the procedure (p = 0.0662), a higher total number of complications was noted in the group that used misoprostol (n = 7; 5.26%) compared with the group that did not use the drug (n = 1; 0.75%), a fact that is clinically relevant. When evaluating the ease of the technique (measured by the complete performance of all steps of the hysteroscopy procedure), it was verified that although there was no difference between groups (p = 0.0586), the control group had more than twice as many incompletely performed procedures (n = 17) when compared with the group that used misoprostol previously (n = 8), which is also clinically relevant. CONCLUSION: The use of misoprostol prior to hysteroscopy in our service indicated that the drug can facilitate the performance of the procedure, but not without side effects and presenting higher complication rates.

OBJETIVO: Avaliação do misoprostol prévio à histeroscopia quanto à facilidade técnica, efeitos colaterais e a ocorrência de complicações durante o procedimento. MéTODOS: Estudo analítico observacional retrospectivo tipo caso controle com revisão de prontuários de 266 pacientes do Setor de Videoendoscopia Ginecológica do Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto - Universidade de São Paulo (HCFMRP ­ USP), de 2014 a 2019, sendo comparadas 133 pacientes que utilizaram o medicamento prévio ao procedimento com 133 pacientes que não o utilizaram. RESULTADOS: Sangramento uterino após a menopausa foi a principal indicação de histeroscopia, apresentando diferença estatística (p < 0,001), estando presente em 93,23% das pacientes do grupo de estudo e em 69,17% das pacientes do grupo controle. Apenas 2 pacientes (1,5%) do grupo de estudo relataram efeitos adversos. Não foram observadas diferenças quanto à presença de complicações durante o procedimento (p = 0,0662), mas observamos um número total de complicações maior no grupo de estudo (n = 7; 5,26%) do que no grupo controle (n = 1; 0,75%), o que é clinicamente relevante. Não houve diferença entre os grupos quanto à facilidade técnica (p = 0,0586), mas o grupo controle apresentou mais do que o dobro de procedimentos não completamente realizados (n = 17) quando comparado com o grupo de estudo (n = 8), o que é clinicamente relevante. CONCLUSãO: O uso de misoprostol prévio à histeroscopia no nosso serviço demonstrou que ele pode facilitar a realização do procedimento, mas não é isento de efeitos colaterais e apresenta maiores taxas de complicações.

A propensity score-matched case-control study of laparoscopy and laparotomy for endometrial cancer.

OBJECTIVE: A surgery is essential for the management of early endometrial carcinoma. Due to the comorbidities associated with the disease, the complications of surgery are common. Laparoscopic surgery may reduce surgical complications but also have oncological risks. We aimed to compare recurrence and overall survival (OS) associated with laparoscopy and laparotomy for early endometrial cancer. METHODS: We included women treated for presumed early endometrial carcinoma at the Clinics Hospital of Ribeirão Preto Medical School from January 1998 to December 2017. We designed a 1:2 propensity score-matched case-control and compared the patients' characteristics, short-term outcomes, recurrence, and OS. RESULTS: A total of 252 women were included in this study, 168 underwent laparotomy, and 84 underwent laparoscopy. The two groups were well balanced according to most of the variables, and obesity was a characteristic of patients in both groups. Laparoscopy was associated with increased surgical time (194.7 min vesus 165.6 min; p<0.001) and reduced rate of surgical complications (6.5% versus 0; p=0.038). Laparoscopic surgery was not associated with the risk of tumor recurrence (HR: 0.41, 95%CI 0.14-1.19, p=0.100) or all-cause mortality (HR: 0.49, 95%CI 0.18-1.35, p=0.170). CONCLUSION: Laparoscopy was safe in terms of oncological outcomes and was associated with a lower rate of surgical complications. Our data support the use of minimally invasive surgery as the preferential approach in the management of early endometrial carcinoma.

Endometriose: aspectos clínicos do diagnóstico ao tratamento / Endometriosis: clinical aspects from diagnosis to treatment

A suspeita clínica de endometriose geralmente envolve a história clínica da paciente e exame físico, abordando sua sintomatologia e história pessoal e familiar. Entretanto, a apresentação clínica da doença varia consideravelmente, sem características clínicas patognomônicas, fato que dificulta o seu diagnóstico. Um diagnóstico presuntivo de endometriose pode ser fortemente sugerido pela ultrassonografia transvaginal e pela ressonância magnética em casos de endometrioma ou endometriose infiltrativa profunda. No entanto, esses exames de imagem não possuem a sensibilidade e a especificidade necessárias quando se trata de endometriose peritoneal superficial. O biomarcador sérico mais utilizado na investigação da endometriose foi o CA-125, que não apresenta sensibilidade (70%-75%) suficiente para sua indicação na prática clínica. Portanto, apesar de seu risco e alto custo, a videolaparoscopia e a análise anatomopatológica subsequente ainda se apresentam como o procedimento padrão-ouro para o diagnóstico definitivo de endometriose. Assim, com o objetivo de demonstrar quais exames seriam necessários para o diagnóstico dessa doença, realizamos uma revisão sistemática da literatura, cujos dados estão descritos a seguir.(AU)

Cirurgia ginecológica e COVID-19: qual o impacto e como devo conduzir? / Gynecological Surgery and COVID-19: What is the Impact and How Should I Manage it?

Estima-se que cerca de 28 milhões de cirurgias sejam postergadas ou canceladas no mundo em decorrência desta pandemia, causando atraso no diagnóstico e tratamento de mais de 2 milhões de casos oncológicos. No Brasil, tanto a ANS (Agência Nacional de Saúde) como a Anvisa (Agência Nacional de Vigilância Sanitária) orientaram o adiamento das cirurgias eletivas e não essenciais, tendo um impacto considerável no número de procedimentos cirúrgicos, com diminuição de 33,4% neste período no Brasil. No entanto, algumas mulheres necessitam de tratamento para várias doenças ginecológicas, algumas das quais não podem ser adiadas. O objetivo deste artigo é apresentar recomendações sobre o tratamento cirúrgico durante a pandemia de COVID-19.(AU)

The Influence of Education and Depression on Autonomy of Women with Chronic Pelvic Pain: A Cross-sectional Study / A influência da educação e depressão sobre a autonomia de mulheres com dor pélvica crônica: um estudo transversal

Objective Patient autonomy has great importance for a valid informed consent in clinical practice. Our objectives were to quantify thedomains of patient autonomy and to evaluate the variables that can affect patient autonomy in women with chronic pelvic pain. Methods This study is a cross sectional survey performed in a tertiary care University Hospital. Fifty-two consecutive women scheduled for laparoscopic management of chronic pelvic were included. Three major components of autonomy (competence, information or freedom) were evaluated using a Likert scale with 24 validated affirmatives. Results Competence scores (0.85 vs 0.92; p = 0.006) and information scores (0.90 vs 0.93; p = 0.02) were low for women with less than eight years of school attendance. Information scores were low in the presence of anxiety (0.91 vs 0.93; p = 0.05) or depression (0.90 vs 0.93; p = 0.01). Conclusions Our data show that systematic evaluation of patient autonomy can provide clinical relevant information in gynecology. Low educational level, anxiety and depression might reduce the patient autonomy in women with chronic pelvic pain.

Objetivo A autonomia da paciente é de grande importância para que o consentimento informado seja válido na prática clínica. Nossos objetivos foram quantificar os domínios da autonomia e avaliar variáveis que modificam a autonomia em mulheres com dor pélvica crônica. Métodos Este é um estudo transversal realizado em um Hospital Universitário terciário. Foram incluídas consecutivamente 52 mulheres com dor pélvica crônica agendadas para videolaparoscopia. Foi utilizada uma escala Likert com 24 afirmativas validadas para quantificar os três principais componentes da autonomia (competência, informação e liberdade). Resultados Os escores de competência (0,85 vs 0,92; p = 0,006) e informação (0,90 vs 0,93; p = 0,02) foram menores para mulheres com ensino fundamental incompleto. Os escores de informação foram menores em mulheres com sintomas de ansiedade (0,91 vs 0,93; p = 0,05) ou depressão (0,90 vs 0,93; p = 0,01). Conclusões Nossos dados mostram que a quantificação da autonomia pode produzir informações relevantes para a prática clínica em ginecologia. O nível educacional e a presença de ansiedade e depressão podem afetar a autonomia de mulheres com dor pélvica crônica.

System for storing, recovering, and comparing gene expressioninformation from patients with endometriosis / Sistema para armazenamento, recuperação e comparação de informações sobre expressão gênica empacientes com endometriose / Sistema de almacenamiento, recuperación y comparación de Informaciones sobre expresión génica en pacientes con endometriosis

Objective: To develop a web-based system to store, recover, compare, and associate information obtained using high-throughput molecular genetic techniques regarding differentially expressed genes in patients with endometriosis. Methods: A web-based tool was developed using the Java programming and XHTML markup languages. Professionals and researchers in the contributed to the database by uploading research data from scientific articles in which screening techniques had been performed to determine differential gene expression in women with and without endometriosis. Results: a web-based system with the main functionalities of article registration and gene searching was developed. These functions allow the user to identify coincidences between the results reported in the registered articles regarding differential gene expression. Conclusion: The developed tool allows for the collection of principal data regarding dysregulated gene expression in endometriosis and highlights candidate genes for future studies to better understand the etiopathogenesis of this disease.

Objetivo: O presente trabalho apresenta o primeiro sistema em ambiente web capaz de armazenar, recuperar,comparar e relacionar informações sobre expressão gênica em larga escala em pacientes com endometriose. Métodos:A ferramenta foi desenvolvida em ambiente web utilizando-se a linguagem de programação Java e a linguagem demarcação XHTML. O banco de dados foi alimentado por profissionais e pesquisadores da área, utilizando dados de pesquisas relatadas em artigos científicos, nas quais foram realizadas técnicas de screening para expressão gênica diferencial em pacientes com e sem endometriose. Resultados: Entre as principais funcionalidades do sistema destacam-se o cadastro de artigos e busca de genes. Tais funções permitem que o usuário identifique coincidências entre os resultados de expressão gênica registrados nos artigos cadastrados no sistema. Conclusão: A ferramenta desenvolvida permite reunir os principais dados referentes às alterações de expressão gênica na endometriose,contribuindo para uma melhor compreensão da origem da doença.

Objetivo: En este trabajo se presenta el primer sistema capaz de almacenar, recuperar, comparar y relacionar en web, informaciones sobre expresión génica en gran escala en pacientes con endometriosis. Métodos: La herramienta se ha desarrollado en web utilizando el lenguaje de programación Java y el lenguaje XHTML. La base de datos fue generada por profesionales e investigadores, con datos de investigaciones publicadas en artículos científicos, en donde se efectuaron las técnicas para la detección de expresión diferencial de genes en pacientes con presencia y ausencia de endometriosis. Resultados: Entre las principales características del sistema se incluyen registros de artículos y búsqueda de genes. Estas funciones permiten que el usuario identifique similitudes entre los resultados de expresión de genes grabados en los artículos registrados en el sistema. Conclusión: Esta herramienta ha permitido reunir datos de variaciones de expresión génica en la endometriosis, lo que contribuye a una mejor comprensión del origen de esta enfermedad.

Caldesmon: new insights for diagnosing endometriosis.

Considerable effort has been invested in searching for less invasive methods of diagnosing endometriosis. Previous studies have indicated altered levels of the CALD1 gene (encoding the protein caldesmon) in endometriosis. The aims of our study were to investigate whether average CALD1 expression and caldesmon protein levels are differentially altered in the endometrium and endometriotic lesions and to evaluate the performance of the CALD1 gene and caldesmon protein as potential biomarkers for endometriosis. Paired biopsies of endometrial tissue (eutopic endometrium) and endometriotic lesions (ectopic endometrium) were obtained from patients with endometriosis to evaluate CALD1 gene expression and caldesmon protein levels by real-time PCR and Western blot analysis, respectively. In addition, immunostaining for caldesmon to determine cellular localization was also performed. Endometrium from women without endometriosis was used as a control. Increased CALD1 expression and caldesmon levels were detected in the endometriotic lesions. The electrophoretic profile of caldesmon by Western blot analysis was clearly different between the control group (endometrium of women without endometriosis) and the group of women with endometriosis (eutopic endometrium and endometriotic lesions). Caldesmon expression as determined by immunostaining showed no variation among the cell types in endometriotic lesions and eutopic endometrium. Stromal cells marked positively in eutopic endometrium from control patients and in the endometriotic lesions. The presence of caldesmon in the endometrium of patients with and without endometriosis permitted diagnoses with 95% sensitivity (specificity 100%) and 100% sensitivity (specificity 100%) for the disease and for minimal to mild endometriosis in the proliferative phase of the menstrual cycle, respectively. In the secretory phase, minimal to mild endometriosis was detected with 90% sensitivity and 93.3% specificity. Caldesmon is a possible predictor of endometrial dysregulation in patients with endometriosis. A potential limitation of our study is the fact that other endometrial diseases were not excluded, and therefore prospective studies are needed to confirm the potential of caldesmon as a biomarker exclusively for endometriosis.

High prevalence of chronic pelvic pain in women in Ribeirão Preto, Brazil and direct association with abdominal surgery.

INTRODUCTION: Chronic pelvic pain is a disease that directly affects the social and professional lives of women. OBJECTIVE: To estimate the prevalence of this clinical condition and to identify independent factors associated with it in women living in Ribeirão Preto, Brazil. METHODS: A one-year cross-sectional study was conducted in a population sample of 1,278 women over the age of 1,278 women over the age of 14 years. The target population was predominantly composed of women who are treated by the public health system. The questionnaire was administered by interviewers who were not linked to the city health care programs. The prevalence of the morbidity was estimated. First, we identified the significant variables associated with pelvic pain (p<0.10) and then we attributed values of 0 or 1 to the absence or presence of these variables. Logistic regression analysis was used to identify and estimate the simultaneous impact of the independent variables. The results were expressed by odds ratio and their 95% confidence interval with p<0.05. RESULTS: The disease was found in 11.5% (147/1,278) of the sample. The independent predictors were dyspareunia, previous abdominal surgery, depression, dysmenorrhea, anxiety, current sexual activity, low back pain, constipation, urinary symptoms, and low educational level. CONCLUSION: The prevalence of chronic pelvic pain in Ribeirão Preto is high and is associated with conditions that can usually be prevented, controlled, or resolved by improvement of public health policies and public education.

High prevalence of chronic pelvic pain in women in Ribeirão Preto, Brazil and direct association with abdominal surgery

INTRODUCTION: Chronic pelvic pain is a disease that directly affects the social and professional lives of women. OBJECTIVE: To estimate the prevalence of this clinical condition and to identify independent factors associated with it in women living in Ribeirão Preto, Brazil. METHODS: A one-year cross-sectional study was conducted in a population sample of 1,278 women over the age of 1,278 women over the age of 14 years. The target population was predominantly composed of women who are treated by the public health system. The questionnaire was administered by interviewers who were not linked to the city health care programs. The prevalence of the morbidity was estimated. First, we identified the significant variables associated with pelvic pain (p<0.10) and then we attributed values of 0 or 1 to the absence or presence of these variables. Logistic regression analysis was used to identify and estimate the simultaneous impact of the independent variables. The results were expressed by odds ratio and their 95 percent confidence interval with p<0.05. RESULTS: The disease was found in 11.5 percent (147/1,278) of the sample. The independent predictors were dyspareunia, previous abdominal surgery, depression, dysmenorrhea, anxiety, current sexual activity, low back pain, constipation, urinary symptoms, and low educational level. CONCLUSION: The prevalence of chronic pelvic pain in Ribeirão Preto is high and is associated with conditions that can usually be prevented, controlled, or resolved by improvement of public health policies and public education.