Laparoscopic Plication and Suspension of the Round Ligament for Chronic Pelvic Pain and Dyspareunia

Sertaç Batıoğlu, Hulusi Bülent Zeyneloğlu
In: The Journal of the American Association of Gynecologic Laparoscopists · 2000 · vol. 7(4) , pp. 547–551 · doi:10.1016/s1074-3804(05)60373-8 · PMID:11044511 · W2010324406
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This study describes a laparoscopic surgical technique using plication and suspension of the round ligament to treat patients experiencing chronic pelvic pain and dyspareunia.

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Abstract

Study objectiveTo describe a technique of uterine suspension using round ligaments to relieve pain in selected patients with various degrees of uterine retroversion.DesignProspective clinical study (Canadian Task Force classification II-2).SettingUniversity-based center for reproductive medicine.PatientsThirty women who underwent laparoscopy for investigation of chronic pelvic pain (CPP) and dyspareunia.InterventionRound ligaments were plicated using a modification of intracorporeal knot tying during laparoscopy.Measurements and main resultsThe extent of plication was planned to elevate the uterus and bring it minimally forward. Mean +/- SD operating time was 14+/-4 minutes. Pain scores before and after surgery were 4.5+/-1.0 and 1.6+/-0.6, respectively (p<0.001). There were no complications during or after surgery. Only three women had minimal dyspareunia postoperatively, although they had anteverted uteri. One patient had severe dyspareunia that developed 7 months after surgery and continued through the second year of follow-up. Nineteen women with anteverted uteri were free of dyspareunia after 2 years.ConclusionRound ligament plication is safe and effective in patients with retroverted uteri and dyspareunia or CPP.

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chronic_pelvic_paindyspareunia

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