The Prevesical Fascia: A Fascial Target in Abdominal Myofascial Pain Syndrome-A Case Report.

Chronic abdominal myofascial pain syndrome is frequently underdiagnosed and often refractory to conventional pharmacological and superficial interventional treatments. While muscular trigger points are commonly implicated, growing evidence supports an active nociceptive role of deep fascial structures of the anterior abdominal wall. We report a case of refractory chronic suprapubic pain successfully treated by targeting the prevesical (Retzius) fascial compartment through a bilateral deep rectus sheath injection. The prevesical fascia may represent a clinically relevant but under-recognized pain generator, and targeting this compartment may be considered as a therapeutic option in refractory suprapubic myofascial pain.