Subjective evaluation of the therapeutic value of laparoscopic adhesiolysis

E Malik, Eduard Malik, C Berg, A Meyhöfer-Malik, S Haider, Syed F. Haider, W G Rossmanith
Surgical endoscopy · 2000 · vol. 14(1) , pp. 79–81 · doi:10.1007/s004649900017 · PMID:10653243 · W2329924858
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This retrospective study found that laparoscopic adhesiolysis ameliorated or completely relieved functional irritations in nearly one-third of patients with chronic pelvic pain.

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This retrospective study evaluated patient-reported discomfort before laparoscopic adhesiolysis and at up to 1.5 years after surgery in 187 patients treated at the Medical University of Ulm, Germany, aiming to quantify the therapeutic value of adhesiolysis for chronic pelvic pain. Nearly one-third of patients reported functional irritations that were ameliorated or completely relieved by the procedure, and when other chronic pain causes (including endometriosis) were excluded, most patients benefited. The authors note a major caveat that pelvic pain can have organic or functional causes other than adhesions, so complete adhesiolysis in patients with persistent pain may be of limited importance. Relevance to endometriosis: endometriosis is explicitly mentioned as an example of other chronic pain causes that were excluded when interpreting benefit, though the paper’s main focus is laparoscopic adhesiolysis for chronic pelvic pain due to adhesions.

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Abstract

Background Adhesions are believed to be one of the principal causes of chronic pelvic pain. Although there may be some discrepancy between the degree of adhesions and the severity of the symptoms, surgical adhesiolysis is still considered to be useful for the relief of pain.

Methods

A total of 187 patients who underwent laparoscopic adhesiolysis at the Medical University of Ulm, Germany, within a 2-year period were asked to rank their discomfort on a visual pain scale before surgery and up to 1 1/2 years postoperatively.

Results

In this retrospective study, we found that nearly one-third of patients suffered from functional irritations that were either ameliorated or completely relieved by laparoscopic adhesiolysis. When other causes of chronic pain (such as endometriosis) are excluded, the results show that most patients benefited from laparoscopic adhesiolysis.

Conclusions

It appears that laparoscopic adhesiolysis is an effective therapeutic measure to relieve chronic pelvic pain. Therefore, adhesiolysis should be performed in all patients with chronic or intermittent pain, and a complete lysis of adhesions should be planned. However, since pelvic pain may have organic or functional causes other than adhesions, complete adhesiolysis in patients with persistent pelvic pain may be of only limited importance. Similar content being viewed by others

References

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Condition tags

chronic_pelvic_pain

MeSH descriptors

Laparoscopy Laparoscopy Pelvic Pain Pelvis Tissue Adhesions Adult Aged Chronic Disease Female Humans Middle Aged Pain Measurement Pelvic Pain Pelvis Retrospective Studies Tissue Adhesions Tissue Adhesions

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