Laparoscopy and Reported Pain among Patients with Endometriosis

John Jarrell, Jarrell J, Ruchi Mohindra, Mohindra R, Sue Ross, Ross S, Taenzer P, Paul Taenzer, Rollin Brant
Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC · 2005 · vol. 27(5) , pp. 477–485 · doi:10.1016/s1701-2163(16)30531-x · PMID:16100643 · W2340340272
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This paper describes the use of laparoscopy in managing endometriosis and reports on patient experiences with pain.

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Abstract

ObjectiveTo compare the effectiveness of sharp excision of endometriosis with sham surgical excision in alleviating endometriosis-associated pain for up to 1 year following surgery.MethodsPatients requiring a laparoscopy for severe pelvic pain were eligible. If endometriosis was visually identified at laparoscopy, a biopsy of a representative lesion was taken. The women were then randomized either to have all remaining endometriosis excised with laparoscopic scissors (the excision group) or to have no further surgical treatment (the control group). Patients were asked to complete daily pain scales for 1 month preoperatively and quarterly for 1 year postoperatively. Subjects were blinded to their treatment allocation for 1 year.ResultsTwenty-nine women underwent laparoscopy and biopsy and were randomized to have excision or no treatment of endometriosis. The excision and control groups were similar in age, parity, and revised American Society for Reproductive Medicine stage of disease. Sixteen women completed the full year of follow-up: 9 in the excision group, and 7 in the control group. Overall, recorded pain was significantly reduced at 1 year (P < 0.05), with no significant difference between the excision and control groups.ConclusionLaparoscopy with diagnostic biopsy alone is associated with a significant reduction in pain for up to 1 year postoperatively. Although the study lacked sufficient statistical power to exclude an effect of excision, pain relief in each group was similar. These results indicate a potential benefit of sham surgical procedures in assessing novel surgical interventions.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Laparoscopy Adult Endometriosis Endometriosis Female Humans Laparoscopy Pain Measurement Placebos Severity of Illness Index Single-Blind Method Treatment Outcome

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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