Role of laparoscopy in evaluation of chronic pelvic pain

Shripad Hebbar, Chander Chawla

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Introduction: Chronic pelvic pain (CPP) is a common medical problem affecting women. Too often the physical signs are not specific. This study aims at determining the accuracy of diagnostic laparoscopy over clinical pelvic examination. Settings and Design: A retrospective study of patients who underwent diagnostic laparoscopy for CPP. Materials and Methods: The medical records of 86 women who underwent laparoscopic evaluation for CPP of at least 6-month duration were reviewed for presentation of symptoms, pelvic examination findings at the admission, operative findings and follow up when available. Statistical analysis used: McNemar Chi-square test for frequencies in a 2 x 2 table. Results: The most common presentation was acyclic lower abdominal pain (79.1%), followed by congestive dysmenorrhoea (26.7%). 61.6% of women did not reveal any significant signs on pelvic examination. Pelvic tenderness was elicited in 27.9%. Diagnostic laparoscopy revealed significant pelvic pathology in 58% of those who essentially had normal pervaginal findings. The most common pelvic pathology by laparoscopy was pelvic adhesions (20.9%), followed by pelvic congestion (18.6%). Laparoscopic adhesiolyis achieved pain relief only in one-third of the women. Conclusion: The study revealed very low incidence of endometriosis (4.7%). Overall clinical examination could detect abnormality in only 38% of women, where as laparoscopy could detect significant pathology in 66% of women with CPP. This shows superiority of diagnostic laparoscopy over clinical examination in detection of aetiology in women with CPP (P < 0.001). Adhesiolysis helps only small proportion of women in achieving pain control.

Original languageEnglish
Pages (from-to)116-120
Number of pages5
JournalJournal of Minimal Access Surgery
Volume1
Issue number3
Publication statusPublished - 01-07-2005

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Pelvic Pain
Chronic Pain
Laparoscopy
Gynecological Examination
Pathology
Pain
Dysmenorrhea
Endometriosis
Chi-Square Distribution
Abdominal Pain
Medical Records
Retrospective Studies
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

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title = "Role of laparoscopy in evaluation of chronic pelvic pain",
abstract = "Introduction: Chronic pelvic pain (CPP) is a common medical problem affecting women. Too often the physical signs are not specific. This study aims at determining the accuracy of diagnostic laparoscopy over clinical pelvic examination. Settings and Design: A retrospective study of patients who underwent diagnostic laparoscopy for CPP. Materials and Methods: The medical records of 86 women who underwent laparoscopic evaluation for CPP of at least 6-month duration were reviewed for presentation of symptoms, pelvic examination findings at the admission, operative findings and follow up when available. Statistical analysis used: McNemar Chi-square test for frequencies in a 2 x 2 table. Results: The most common presentation was acyclic lower abdominal pain (79.1{\%}), followed by congestive dysmenorrhoea (26.7{\%}). 61.6{\%} of women did not reveal any significant signs on pelvic examination. Pelvic tenderness was elicited in 27.9{\%}. Diagnostic laparoscopy revealed significant pelvic pathology in 58{\%} of those who essentially had normal pervaginal findings. The most common pelvic pathology by laparoscopy was pelvic adhesions (20.9{\%}), followed by pelvic congestion (18.6{\%}). Laparoscopic adhesiolyis achieved pain relief only in one-third of the women. Conclusion: The study revealed very low incidence of endometriosis (4.7{\%}). Overall clinical examination could detect abnormality in only 38{\%} of women, where as laparoscopy could detect significant pathology in 66{\%} of women with CPP. This shows superiority of diagnostic laparoscopy over clinical examination in detection of aetiology in women with CPP (P < 0.001). Adhesiolysis helps only small proportion of women in achieving pain control.",
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Role of laparoscopy in evaluation of chronic pelvic pain. / Hebbar, Shripad; Chawla, Chander.

In: Journal of Minimal Access Surgery, Vol. 1, No. 3, 01.07.2005, p. 116-120.

Research output: Contribution to journalArticle

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