O papel da laparoscopia diagnóstica em ginecologia

Raquel Togni, Cristina Laguna Benetti-Pinto, Daniela Angerame Yela
In: instacron:APM · 2016 · W7120874136
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This study evaluated 618 women undergoing diagnostic laparoscopy for infertility and chronic pelvic pain, finding tubal alterations most common in infertility and peritoneal alterations in pelvic pain, though most procedures revealed no abnormalities.

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This retrospective descriptive study evaluated indications and intraoperative findings for diagnostic videolaparoscopy in an endoscopic gynecology clinic, analyzing medical records from 618 women who underwent procedures between 2008 and 2012. The main indications were infertility (57%) and chronic pelvic pain (27%), with other causes (e.g., intrauterine device, adnexal tumor, ectopic pregnancy, pelvic inflammatory disease) accounting for 16%, and the most frequent findings were tubal alterations among infertility cases and peritoneal alterations among chronic pelvic pain cases. The authors found that in most procedures there were no abnormalities that justified the presenting complaints. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

CONTEXT AND OBJECTIVES: Laparoscopy is a diagnostic method that is currently becoming consolidated for therapeutic use. It consists of endoscopically viewing the abdominal cavity. The aim here was to evaluate the indications for diagnostic videolaparoscopy and the intraoperative findings in an endoscopic gynecology clinic at a tertiary-level hospital over the last five years. DESIGN AND SETTING: Retrospective descriptive study on all diagnostic videolaparoscopy procedures of the last five years carried out in the endoscopic gynecology clinic of a tertiary-level hospital. METHODS: The medical records of 618 women who underwent diagnostic laparoscopy between 2008 and 2012 were analyzed. The clinical characteristics of these women, the indications for videolaparoscopy and the intraoperative findings were evaluated. RESULTS: The women’s mean age was 32 ± 6.4 years. Most of the women had already undergone at least one previous operation (60%), which was most frequently a cesarean. The indications for performing videolaparoscopy were infertility in 57%, chronic pelvic pain in 27% and others (intrauterine device, adnexal tumor, ectopic pregnancy or pelvic inflammatory disease) in 16%. The main laparoscopic findings were tubal alterations in the group with infertility (59.78%) and peritoneal alterations in the group with chronic pelvic pain (43.54%). CONCLUSION: The main indications for videolaparoscopy in gynecology were infertility and chronic pelvic pain. However, in most procedures, no abnormalities justifying these complaints were found.
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Keywords

Laparoscopy, Infertility, Pelvic pain, Endometriosis, EndoscopyAbstract CONTEXT AND OBJECTIVES: Laparoscopy is a diagnostic method that is currently becoming consolidated for therapeutic use. It consists of endoscopically viewing the abdominal cavity. The aim here was to evaluate the indications for diagnostic videolaparoscopy and the intraoperative findings in an endoscopic gynecology clinic at a tertiary-level hospital over the last five years. DESIGN AND SETTING: Retrospective descriptive study on all diagnostic videolaparoscopy procedures of the last five years carried out in the endoscopic gynecology clinic of a tertiary-level hospital. METHODS: The medical records of 618 women who underwent diagnostic laparoscopy between 2008 and 2012 were analyzed. The clinical characteristics of these women, the indications for videolaparoscopy and the intraoperative findings were evaluated. RESULTS: The women’s mean age was 32 ± 6.4 years. Most of the women had already undergone at least one previous operation (60%), which was most frequently a cesarean. The indications for performing videolaparoscopy were infertility in 57%, chronic pelvic pain in 27% and others (intrauterine device, adnexal tumor, ectopic pregnancy or pelvic inflammatory disease) in 16%. The main laparoscopic findings were tubal alterations in the group with infertility (59.78%) and peritoneal alterations in the group with chronic pelvic pain (43.54%). CONCLUSION: The main indications for videolaparoscopy in gynecology were infertility and chronic pelvic pain. However, in most procedures, no abnormalities justifying these complaints were found. Downloads

References

Crispi CP. Tratado de videoendoscopia e cirurgia minimamente invasi- va em ginecologia: fundamentos, videolaparoscopia, uroginecologia, video-histeroscopia. 2a edição. Rio de Janeiro: Revinter; 2007. Ikechebelu JI. Experience with diagnostic laparoscopy for gyneco- logical indications. Niger J Clin Pract. 2013;16(2):155-8. Aziz N. Laparoscopic evaluation of female factors in infertility. J Coll Physicians Surg Pak. 2010;20(10):649-52. Baloch S, Khaskheli MN, Malik AM. Diagnostic laparoscopic findings in chronic pelvic pain. J Coll Physicians Surg Pak. 2013;23(3):190-3. Hodav Y, Hornstein E, Almagor M, Yaffe C. Diagnostic laparoscopy in primary and secondary infertility. J Assist Reprod Genet. 1998;15(9):535-7. Kahyaoglu S, Kahyaoglu I, Yilmaz B, et al. Should diagnostic laparoscopy be performed initially or not, during infertility management of primary and secondary infertile women? A cross- sectional study. J Obstet Gynecol Res. 2009;35(1):139-44. Göçmen A, Atak T. Diagnostic laparoscopy findings in unexplained infertility cases. Clin Exp Obstet Gynecol. 2012;39(4):452-3. Demir F, Ozcimen EE, Oral HB. The role of gynecological, urological, and psychiatric factors in chronic pelvic pain. Arch Gynecol Obstet. 2012;286(5):1215-20.

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chronic_pelvic_paininfertility

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