ABSTRACT

The Bornstein Test to check for origin of chronic pelvic pain was first applied in 2005 to challenge the hypothesis that the causation of vulvodynia may not be from the vulva itself, but from laxity in the uterosacral ligaments. It has been subsequently successfully applied to patients with Interstitial Cystitis. The Bornstein local anesthetic (LA) test technique: The lower half of a bivalve speculum is inserted into the vagina. The cervix or hysterectomy scar are visualized, gently grasped with an Allis forceps then gently stretched towards the introitus. The USLs are located by digital palpation. A 21 gauge needle attached to a 10ml syringe loaded with 1% xylocaine is inserted through the vaginal mucosa to a depth of 1.5 cm at 4 and 8 o’clock in a position just lateral to the uterosacral ligaments (USLs). 5 ml of 1% xylocaine are injected on each side. After the elapse of 5 minutes, the patient is checked to see if sensitivity is relieved. Conclusions: The Bornstein Test is a valuable clinical and research tool for assessing whether chronic pelvic pain has its origins in the nerve plexuses of the uterosacral ligaments.