BACKGROUND: Endometriosis is a common cause of chronic pelvic pain which can relapse after surgery, yet little research has been conducted on women's experience of medical treatments for prevention of recurrence and the influence of this on…
CONSORT flow diagram and Checklist. (DOCX 34 kb)
CONSORT flow diagram and Checklist. (DOCX 34 kb)
BACKGROUND: Endometriosis is associated with the growth of endometrium in ectopic sites mainly within the pelvis. This results in inflammation and scarring, causing pain and impaired quality of life. Endometriotic lesions can be excised or …
BACKGROUND: Heavy menstrual bleeding (HMB) is a common problem, yet evidence to inform decisions about initial medical treatment is limited. OBJECTIVES: To assess the clinical effectiveness and cost-effectiveness of the levonorgestrel-rele…
BACKGROUND: Uterine fibroids are the most common tumour in women of reproductive age. By the time they are 50-years-old around 80% of women will have developed one. Of these, around half will experience symptoms which will impact negatively…
Part One: Chronic Pelvic PainChapter 2 reviews the current thinking and evidence base for diagnostic tests and medical, surgical and psychological therapies.Chapter 3 illustrates the situation regarding use of laparoscopic uterosacral nerve…
BACKGROUND: Menorrhagia is a common problem, yet evidence to inform decisions about therapy is limited. In a pragmatic, multicenter, randomized trial, we compared the levonorgestrel-releasing intrauterine system (levonorgestrel-IUS) with us…
According to the original receptor occupancy theory proposed by Clark in the 1930s, the percent occupancy of total available receptors by an agonist is linearly related to the response (or effect). However, the first recognition of "recepto…
Chronic pelvic pain (CPP), a common cause of disability in women, is a condition best viewed in the biopsychosocial framework. Psychological interventions are frequently considered alongside medical and surgical treatments. Our objective wa…
Menorrhagia, or heavy menstrual bleeding (HMB), is a common gynaecological condition. As the aim of treatment is to improve women's wellbeing and quality of life (QoL), it is necessary to have effective ways to measure this. This study inve…
#### Summary points Chronic pelvic pain in women is a debilitating condition that impairs quality of life. Studies using various definitions estimated that its prevalence ranges from 2.1% to 24% of the female population worldwide.1 It is a…
Abstract Randomized control trials (RCTs) are widely accepted as a gold standard for scientific evaluation of all treatments. Benign gynecological conditions such as chronic pelvic pain, heavy menstrual bleeding, and subfertility can be tre…
BACKGROUND: There have been conflicting results in randomized trials of the effects of laparoscopic uterosacral nerve ablation (LUNA) in chronic pelvic pain. Our objective was to perform a meta-analysis using individual patient data (IPD) t…
BACKGROUND: Adenomyosis is a common condition that causes substantial morbidity. Until recently, the reference standard for a definitive diagnosis was histology of hysterectomy specimens. Ultrasound and magnetic resonance imaging (MRI) may …
CONTEXT: Chronic pelvic pain is a common condition with a major effect on health-related quality of life, work productivity, and health care use. Operative interruption of nerve trunks in the uterosacral ligaments by laparoscopic uterosacra…
BACKGROUND: Currently, there are a number of clinical trials, but no international collaboration for collating research on effectiveness of laparoscopic uterosacral nerve ablation (LUNA) for alleviating chronic pelvic pain. OBJECTIVE: Meta…
To examine the variation in current indications and surgical techniques for performing laparoscopic uterosacral nerve ablation (LUNA) in Europe, all consultants on the databases of the UK Royal College of Obstetricians and Gynaecologists (1…
Objective To determine the current use of and the indications for laparoscopic uterine nerve ablation (LUNA) in the UK, and to establish practitioners' views regarding the desirability of a controlled clinical trial to assess the efficacy o…