The value of laparoscopy in women with chronic pelvic pain and a “normal pelvis”
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Laparoscopy revealed pelvic pathology in only 8.2% of women with chronic pelvic pain and a normal pelvic exam, suggesting routine laparoscopy is of low value and psychological assessment should be prioritized.
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Abstract
During the period January 1976--December 1982 laparoscopy was performed on 186 women complaining of pelvic pain of at least 6 months' duration. In all these cases, the routine pelvic examination and other medical and laboratory tests were negative. Laparoscopy revealed pelvic pathology in only 8.2%: in the vast majority (91.8%) entirely normal pelvic organs were seen. Evidence from the literature is compiling as to the psychogenic origin of most cases of chronic pelvic pain. Recently, it has been shown that laparoscopically negative pelvic pain can be relieved or abolished by psychological intervention. Since pathological findings on laparoscopy are of very low percentage and since the pain is psychogenic in most cases, the value of routine laparoscopy in chronic pelvic pain is very low. We propose that all women with chronic pelvic pain and normal pelvic examination should undergo psychological assessment and treatment if necessary. Laparoscopy should then be reserved for only those cases who show no amelioration on psychological intervention. Our estimation is that this approach would reduce the rate of laparoscopies performed for chronic pelvic pain by about 90%.
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- Laparoscopic Uterine Nerve Ethanol Neurolysis (LUNEN) in Patients with Chronic Pelvic Pain 2016
- Laparoscopic Uterine Nerve Ethanol Neurolysis (LUNEN) in Patients with Chronic Pelvic Pain 2016
- Experience of pelvic peritonectomy in patients with persistent pelvic pain 2008
- Two cases of chronic pelvic pain of unknown origin treated by laparoscopic cutting of right round ligament 2005
- What happens to women with chronic pelvic pain after a negative [normal] laparoscopy? 2005
- Chronic pelvic pain: Sailing between the “ Scylla” and the “ Charybdis” 2005
- The role of laparoscopic surgery in the evaluation of chronic pelvic pain of unknown origin: pitfalls with a negative laparoscopic findings 2003
- Chronische Unterbauch- schmerzen "chronic pelvic pain syndrome" Ein multifaktorielles Krankheitsbild mit Indikation zur interdisziplinären Behandlung 2001
- Laparoscopy in the Management of Pelvic Pain in Calabar, Nigeria 2000
- A cost-effective approach to the management of endometriosis 2000
- Psychological and endocrine correlates of chronic pelvic pain associated with adhesions 1999
- Psychosomatic group treatment helps women with chronic pelvic pain 1999
- Women's Perspectives on their Experiences of Chronic Pelvic Pain and Medical Care 1998
- Laparoscopic and Psychologic Evaluation of Women with Chronic Pelvic Pain 1998
- of pelvic pain in women 1997
- The role of laparoscopy in the management of pelvic pain in women of reproductive age 1997
- Office microlaparoscopy under local anesthesia for chronic pelvic pain 1996
- Comparison of transvaginal sonography and bimanual pelvic examination in patients with laparoscopically confirmed endometriosis 1994
- SURGICAL MANAGEMENT OF CHRONIC PELVIC PAIN 1993
- Valeur diagnostique de l’exploration laparoscopique des femmes souffrant de douleurs pelviennes chroniques: expérience personnelle et revue de la littérature 1992
- Findings in 200 consecutive asymptomatic women, having a laparoscopic sterilization 1990
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