Patient preferences for non-invasive diagnostic biospecimens among women with chronic pelvic pain: A cross-sectional survey

• Urine tests were the preferred option for the diagnosis of endometriosis • Tampon and stool tests were considered to be “uncomfortable” or “embarrassing” • All non-invasive tests were found to be acceptable if accurate for diagnosis Chronic pelvic pain (CPP) frequently prompts visits to gynaecology services, commonly resulting in invasive laparoscopic examinations. Various non-invasive sampling methods are the subject of research, but patient preferences remain largely unexplored. This study aims to delineate the acceptability of different non-invasive biosamples and explore the reasoning behind preferences. A questionnaire was developed to investigate acceptability and preferences regarding the provision and testing of five different biological samples: urine, blood, saliva, vaginal tampons, and faeces. Premenopausal women with CPP and suspected or confirmed endometriosis were recruited between October 2022 and January 2023. Participants were classified into three groups based on laparoscopic findings: superficial or ovarian endometriosis, deep bowel-involving endometriosis, and no endometriosis. Responses were statistically compared between groups. Eighty-seven participants completed the survey. Urine testing was the preferred biosample with 86 (98.8%) respondents ranking it as their first, second or third most preferred sample type. Blood and saliva samples ranked second and third, respectively with 82 (94.3%) and 61 (70.1%) respondents ranking this test third or higher. Tampon (28, (32.2%)) and faeces (4 (4.6%)) tests were ranked lowest and were described as "uncomfortable" or "embarrassing" by 48 (55.1%) and 68 (78.1%) respondents, respectively. There were minimal differences in responses between those with and without endometriosis. Among this cohort, urine testing provided the most acceptable non-invasive sample type, followed by blood and saliva tests. However, respondents indicated that any non-invasive test would be largely acceptable to determine the need for more invasive diagnostic tests.