Depending on the clinical impression and previous investigations, patients with chronic pelvic pain usually need the following:
Detailed medical history and thorough clinical examination
Filling a pain questionnaire and pain calendar
Different microbiological and haematological tests as indicated by presentation mode
Abdominal and pelvic ultrasound scan examination of the pelvis
Site specific pelvic tenderness during menstrual pelvic ultrasound examination will avoid missing clinical diagnosis of 40% of cases of endometriosis
MRI in suspected cases of deep endometriosis of the rectovaginal septum and bladder bed may be helpful, but not for superficial peritoneal endometriosis
Psychological assessment especially in patients with history of depression, sexual or physical abuse, drug misuse and vague symptoms suggestive of somatization
Laparoscopy if the pain had affected the quality of life, or an organic cause is suspected clinically or by imaging techniques.
Chronic pelvic pain associated with infertility is a good indication for laparoscopy as a primary procedure
Cystoscopy may help with the diagnosis of interstitial cystitis