Effect of the First Laparoscopy in an Adolescent and Young Adult Female Population and Its Association With Chronic Pelvic Pain: A Randomised Controlled Trial

Kimberly Nguyen, Joyce Wu, Hayley Mallinder, Madhulikaa Sarjapuram Niranjan, Brigitte Gerstl, Jason Abbott, Rebecca Deans
The Australian & New Zealand journal of obstetrics & gynaecology · 2025 · vol. 65(4) , pp. 530–534 · doi:10.1111/ajo.13930 · PMID:39739556
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This randomized controlled trial investigates the effect of a first laparoscopy versus medical management on chronic pelvic pain and quality of life in adolescent and young adult females.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text ⓘ

This randomized controlled trial investigates the effect of performing a first laparoscopy versus medical management in adolescent and young adult females aged 16–25 with chronic pelvic pain, with participants randomized to a surgical arm (laparoscopy) or non-surgical arm (medical management). Pain and quality of life are assessed at baseline and at 6 weeks, 6 months, 12 months, and 24 months using validated questionnaires, and outcomes will be compared between arms using independent tests with within-arm comparisons using paired tests. The paper notes that laparoscopy in this population is controversial due to concerns about recurrent pain, repeat surgeries, and surgical risks, and also includes a methodological amendment for patients who choose their own management pathway. Relevance to endometriosis: the study addresses chronic pelvic pain in a population where endometriosis is a common differential, though the paper does not explicitly discuss endometriosis or adenomyosis in the provided text and focuses on comparing laparoscopy versus medical management.

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Abstract

BACKGROUND: Chronic pelvic pain (CPP) is a common and debilitating presentation for adolescent and young adult females. Medical management is often utilised as first line therapy with surgical management considered if medical treatment has been unsuccessful. Laparoscopy in this young population remains controversial due to the high recurrence rate of pain, requirement for repeat surgeries and surgical risks. There is a need for prospective, longitudinal studies comparing medical and surgical management to guide management of young patients with CPP. AIMS: To determine the effect of the first laparoscopy in an adolescent and young adult female population and assess its association with CPP. MATERIALS AND METHODS: Patients aged 16-25 will be recruited from the gynaecological service at the study sites. Consented participants will be randomised to the surgical or non-surgical arms. Those in the surgical arm will have a laparoscopy performed and those in the non-surgical arm will be medically managed. At recruitment and at 6 weeks, 6 months, 12 months and 24 months follow-up, patients will complete a number of validated questionnaires assessing pain and quality of life. An amendment was made to methodology to include patients who will choose their management pathway for CPP. RESULTS: An independent t-test or Mann-Whitney U test will be used to compare the questionnaire scores between the surgical and non-surgical groups. For questionnaire scores at baseline and follow-up within the same arm, a paired t-test or Wilcoxon signed-rank test will be used. A p-value of < 0.05 will be statistically significant.
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Abstract

Background Chronic pelvic pain (CPP) is a common and debilitating presentation for adolescent and young adult females. Medical management is often utilised as first line therapy with surgical management considered if medical treatment has been unsuccessful. Laparoscopy in this young population remains controversial due to the high recurrence rate of pain, requirement for repeat surgeries and surgical risks. There is a need for prospective, longitudinal studies comparing medical and surgical management to guide management of young patients with CPP. Aims To determine the effect of the first laparoscopy in an adolescent and young adult female population and assess its association with CPP.

Materials and methods

Patients aged 16–25 will be recruited from the gynaecological service at the study sites. Consented participants will be randomised to the surgical or non-surgical arms. Those in the surgical arm will have a laparoscopy performed and those in the non-surgical arm will be medically managed. At recruitment and at 6 weeks, 6 months, 12 months and 24 months follow-up, patients will complete a number of validated questionnaires assessing pain and quality of life. An amendment was made to methodology to include patients who will choose their management pathway for CPP.

Results

An independent t-test or Mann–Whitney U test will be used to compare the questionnaire scores between the surgical and non-surgical groups. For questionnaire scores at baseline and follow-up within the same arm, a paired t-test or Wilcoxon signed-rank test will be used. A p-value of < 0.05 will be statistically significant. Conflicts of Interest The authors declare no conflicts of interest.

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Condition tags

chronic_pelvic_pain

MeSH descriptors

Chronic Pain Chronic Pain Chronic Pain Chronic Pain Chronic Pain Chronic Pain Chronic Pain Chronic Pain Chronic Pain Chronic Pain Chronic Pain Chronic Pain Chronic Pain Chronic Pain Chronic Pain Chronic Pain Chronic Pain Chronic Pain Chronic Pain Laparoscopy

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