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DIAGNOSIS:
 POPSS syndrome can be strongly suspected on clinical examination usually within 40-50
minutes. Lab tests, x-rays and endoscopies are used primarily to rule out other serious
conditions and are used sparingly.
It is important to rule out other commonly seen conditions which cause groin, lower abdominal
and pelvic pain. Your primary care physicians, gynecologist, general surgeons, are aware of
these conditions and they will be able to diagnose it. After unsuccessful treatments of these
conditions, if the pain persists then think of POPSS syndrome.
Detailed history with emphasis on some of the following points is helping.
a. Pain gets worse on physical activity.
b. Previous history of lower abdominal surgeries, especially multiple surgeries.
c. History of infections in pelvic organs, i.e. cystitis, prostatitis, pelvic inflammatory disease.
d. History of tendonitis in other parts of the body, i.e. tennis elbow, plantar fascitiis, etc.
e. Previous diagnosis of fibromyalgia.
f. Very few gastro-intestinal symptoms.
On physical exam besides detailed examination of the abdomen, including pelvic and rectal
exam, use of seven signs described by us are very helpful in strongly suspecting POPSS
syndrome.
Confirmation of POPSS syndrome is made by giving a series of strategically placed steroid
injections.
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