The diagnostic value of laparoscopy in 2365 patients with acute and chronic pelvic pain

A. Kontoravdis, Kontoravdis A, Chryssikopoulos A, A. Chryssikopoulos, Dimitrios Hassiakos, D Hassiakos, Hassiakos D, A Liapis, Liapis A, Angelos Liapis, Zourlas PA, P A Zourlas
International Journal of Gynecology & Obstetrics · 1996 · vol. 52(3) , pp. 243–248 · doi:10.1016/0020-7292(95)02611-8 · PMID:8775676 · W2098199231
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Diagnostic laparoscopy identified distinct pathological findings and treatment outcomes between patients with acute and chronic pelvic pain, with significant proportions of both groups showing no laparoscopic findings.

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Abstract

OBJECTIVE: To discriminate the etiology in 2365 patients with acute and chronic pelvic pain (APP, CPP). METHODS: Diagnostic laparoscopy was carried out in 736 patients (31.1%) with APP and in 1629 (68.9%) with CPP. In 315 patients (13.3%) the diagnostic procedure was extended to operative laparoscopy. RESULTS: The most frequent laparoscopic findings in patients with APP were acute salpingitis and pelvic adhesions (22.8%) and ectopic pregnancy (19%), while in patients with CPP the most frequent findings were pelvic adhesions (35.4%) and endometriosis (24.6%). In 7.5% of patients with APP and 24% with CPP, laparoscopy did not reveal any pathological finding in the pelvis. Among the 315 patients in whom operative laparoscopy was carried out, 40% suffered from APP and 60% from CPP. In the 446 patients (18.9%) without laparoscopic findings no treatment was given, while of the remaining 905 patients 40% were subjected to laparotomy and 60% received conservative treatment. The total incidence of side effects reached 4.7% and serious side effects resulting from emergency laparotomy occurred in 0.15% of patients with pelvic pain. CONCLUSION: Our results in a large group of patients with pelvic pain show that there are discrepancies in the incidence of laparoscopic findings between patients with APP and CPP. Discrepancies between the two groups of patients were also found during operative laparoscopy, the treatment administered after laparoscopic diagnosis and the complications encountered.

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Condition tags

chronic_pelvic_painendometriosis

MeSH descriptors

Laparoscopy Pelvic Pain Acute Disease Adolescent Adult Chronic Disease Female Humans Middle Aged Pelvic Pain Pelvic Pain Pelvic Pain Postoperative Complications Retrospective Studies Tissue Adhesions

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