Valeur diagnostique de l’exploration laparoscopique des femmes souffrant de douleurs pelviennes chroniques: expérience personnelle et revue de la littérature

Résumé Le pelvis est la région de l’abdomen où la relation entre algies chroniques et lésions tissulaires est la plus difficile à établir. Environ 30 % des patientes souffrant de douleurs pelviennes chroniques ne présentent pas de pathologie démontrée. La présente étude évalue l’apport de la laparoscopie dans le bilan diagnostique des algies pelviennes chroniques, et propose une approche pluridisciplinaire du problème. Summary Nowhere is the relationship between tissue damage and chronic pain so poorly understood as in the pelvis. About 30 % of patients with chronic pelvic pain have no obvious pelvic pathology at laparoscopic evaluation. In this study we expose our laparoscopic findings in women affected with chronic pelvic pain and discuss the value of pathologic and normal findings in comparison with those reported in the literature. We recommend a multidisciplinary approach to the problem. Zusammenfassung In der Beckenregion des Abdomens, ist die Relation zwischen chronischen Beschwerden und pathologischen Veránderungen am schwierigsten zu kláren. Ungefáhr 30 % von Patienten mit chronischen Schmerzen im Bereich des Beckens zeigen keine offensichtlichen pathologischen Veránderungen. Die vorliegende Studie stellt einen Beitrag zur Laparoskopie für die Diagnostik von chronischen pelvinen Beschwerden dar und prädiert für ein multidiziplináres Vorgehen. Riassunto La pelvi è la regione dell’addome dove è più difficile mettere in relazione una sintomatologia dolorosa cronica con una lesione organica. In circa il 30 % dei pazienti affetti da doloro pelvici cronici non viene messa in evidenza nessuna alterazione. Il presente studio valuta l’apporto della laparoscopia e propone un approccio multidisciplinare nella diagnostica del dolore pelvico cronico. Références REITER R.C. - Chronic Pelvic Pain.Cl. Obstet. Gynecol., 1990,33, 117. Levitan Z., Eibschitz I., De Vries K. et al. - The value of laparoscopy in women with chronic pelvic pain and a “normal pelvis”.Int. J. Gynecol. Obstet., 1985, 23–71. KRESCH A.J., SEIFER D.B., SACHS L.B., BARRESE I. - Laparoscopy in 100 Women With Chronic Pelvic Pain.Obstet. Gynecol., 1984,64, 672. BAHARY CM., GORODESKI I.G. - The Diagnostic Value of Laparoscopy in Women with Chronic Pelvic Pain.American Surgeon, 1987,53, 672. CUNANAN Jr. R.G., COUREY N.G., LIPPES J. - Laparoscopic findings in patients with pelvic pain.Am. J. Obstet. Gynecol., 1983,146, 587. RAPKIN A.J., KAMES L.D. - The Pain Management Approach to Chronic Pelvin Pain.J. Reprod. Med., 1987,32, 323. ROSEFF S.J., MURPHY R.A. - Laparoscopy in the Diagnosis and Therapy of Chronic Pelvin Pain.Cl. Obstet. Gynecol., 1990,33, 137. Beard R.W., Pearce S., Highman J.H., Reginald P.W. - Diagnosis of pelvic varicosities in women with chronic pelvic pain.Lancet, 1984,27. BEARD R.W., REGINALD P.W., WADSWORTH J. - Clinical features of women with chronic lower abdominal pain and pelvic congestion.Br. J. Obstet. Gynecol., 1988,95, 153. TAYLOR H.C. - Pelvic pain based on a vascular and autonomic nervous system disorder.Am. J. Obstet. Gynecol., 1954,67, 1177. GALLEGOS N.C., HOBSLEY M. - Recognition and treatment of abdominal wall pain.J. Roy. Soc. Med., 1989,82, 343. APPLEGATE W.V. - Abdominal cutaneous nerve entrapment syndrome.Surgery, 1972,71, 118. SLOCUMB J.C. - Chronic Somatic, Myofascial and Neurogenic Abdominal Pelvic Pain.Cl. Obstet. Gynecol., 1990,33, 145. REITER R.C. - Occult Somatic Pathology in Women with Chronic Pelvin Pain.Cl. Obstet. Gynecol., 1990,33, 154. HOGSTON P. - Irritable bowel syndrome as a cause of chronic pelvin pain in women attending a gynaecologic clinic.Br. Med. J. Clin. Res., 1987,294, 934. BARBALLAS G.A., MEARES E.M. - Female urethral syndrome.Clin. Urodyn. Pros. Urol., 1984,23, 208. THE AMERICAN FERTILITY SOCIETY. - Revised American Society Classification of Endometriosis.Fertil. Steril., 1985,43, 351. CHATMAN D.L. - Pelvic peritoneal defects and endometriosis: Allen-Masters Syndrome revisited.Fertil. Steril., 1981,36, 751. CHATMAN D.L. - Pelvic peritoneal defects and endometriosis: further observations.Fertil. Steril., 1986,46, 711. JANSEN R.P.S., RUSSEL P. - Nonpigmented endometriosis: clinical, laparoscopic and pathologic definition.Am. J. Obstet. Gynecol., 1986,155, 1154. FEAR R.E. - Laparoscopy: a valuable aid in gynecologic diagnosis.Obstet. Gynecol., 1968,31, 297. PENT D. - Laparoscopy: its role in private practice.Am. J. Obstet. Gynecol., 1972,113, 459. CHAPARRO M.V., GHOSH S., NASHED A., PLIAK A. - Laparoscopy for the confirmation and prognostic evaluation of pelvic inflammatory disease.Int. J. Gynecol. Obstet., 1978,15, 307. RAPKIN A.J. - Adhesions and Pelvic Pain: A Retrospective Study.Obstet. Gynecol., 1986,68, 13. CONTI M., LUERTI M., MOLINARI M.A., MUGGIASCA M.L. - Valeur de la laparoscopie dans le diagnostic étiologique des douleurs pelviennes chroniques chez la femme.Acta End., 1988,18, 107. CORNILLIE F.J., OOSTERLYNCK D., LAUWERYNS J.M., KONINCKX P.R. - Deeply infiltrating pelvic endometriosis: histology and clinical significance.Fertil. Steril., 1990,53, 978. VIALA J.L., BOULOT P. - Douleurs pelviennes d’origine gynécologique.Encycl. Méd. Chir. (Paris, France),Gynécologie, 1987,6, 162 A10. TAYLOR H.C. - Vascular congestion and hyperemia. Their effect on function and structure in the female reproductive organs. III. Etiology and therapy.Am. J. Obstet. Gynecol., 1949,57, 654. DUNCAN C.H., TAYLOR H.C. - A psychosomatic study of pelvic congestion.Am. J. Obstet. Gynecol., 1952,64, 1. REGINALD P.W., BEARD R.W., KOONER J.S., MATHIAS C.J. et al. - Intravenous dihydroergotamine to relieve pelvic congestion with pain in young women.Lancet, 1987,2, 351. BEARD R.W., BELSEY E.M, LIEBERMAN B.A., WILKINSON J.C.M. - Pelvic Pain in Women.Am. J. Obstet. Gynecol., 1977,128, 566. BONICA J.J. - Neurophysiologic and pathologic aspects of acute and chronic pain.Arch. Surg., 1977,112, 750. WOOD D.P., WIESNER M.G., REITER R.C. - Psychogenic chronic pelvic pain: diagnosis and management.Cl. Obstet. Gynecol., 1990,33, 179. RENAER M., VERTOMMEN H., NIJS P., WAGEMANS M.A., VAN HEMELRIJCK M.A. - Psychological aspects of chronic pelvic pain in women.Am. J. Obstet. Gynecol., 1979,134, 75. RENAER M. - Chronic pelvic pain without obvious pathology in women: personal observations and a review of the problem.Europ. J. Obstet. Gynecol. Reprod. Biol., 1980,10, 415. MAGNI G., ANDREOLI C., DE LEO D., MARTINOTTI G., ROSSI C.- Psychological profile of women with chronic pelvic pain.Arch. Gynecol. Obstet., 1986,237, 165. GUZINSKI S.M. - Advances in the diagnosis and treatment of chronic pelvic pain.Adv. Psychosom. Med., 1985,12, 124. QUAN M. - Chronic Pelvic Pain.J. Fam. Pract., 1987,3, 283. HAHN M.B., JONES M.M., CARRON H. - Idiopatic Pelvic Pain. The Relationship to Depression.Postgrad. Med., 1989,85, 263. SLOCUMB J.C., KELLNER R., ROSENFELD R.C., PATHAK D. - Anxiety and depression in patients with abdominal pelvic pain syndrome.Gen. Hosp. Psych., 1989,11, 48. Author information Authors and Affiliations About this article Cite this article Federici, D., Muggiasca, M.L. & Conti, M. Valeur diagnostique de l’exploration laparoscopique des femmes souffrant de douleurs pelviennes chroniques: expérience personnelle et revue de la littérature. Acta Endosc 22, 177–186 (1992). https://doi.org/10.1007/BF02965142 Issue date: DOI: https://doi.org/10.1007/BF02965142