[The role of laparoscopy in the evaluation of chronic pelvic pain]

Chronic pelvic pain, defined as cyclic or acyclic pain reported for a minimum of six months, is one of the most common gynecological symptoms and one of the most important in terms of social costs. From January 1987 to December 1991, 127 patients suffering from chronic pelvic pain were submitted to diagnostic laparoscopy at the Department of Obstetrics and Gynecology of the Università Cattolica del Sacro Cuore in Rome. The mean age of the patients was 30 years, ranging from 14 to 46. All patients were submitted to bimanual pelvic examination upon hospital admission, and most of them (No. = 99, 78%) to pelvic ultrasonographic examination. In 117 patients (92%) samples for the isolation of Chlamydia trachomatis in 5-iodo-2-deoxiuridine treated McCoy cell cultures were obtained from the cervix, the endometrium and the cul-de-sac peritoneal fluid. At laparoscopy, in 25 patients (20%) the exam showed normal pelvic anatomy, whereas in 102 patients (80%) some pelvic pathology was found. The most frequent conditions observed were: pelvic adhesions in 55% (No. = 70), endometriosis in 29% of the cases (No. = 37), and other pathologies (non-endometriotic ovarian cysts, hydrosalpinges, myomas, etc.) in 25% of the cases (No. = 32). At the comparison of bimanual examination and laparoscopic findings, out of 71 patients with normal findings at bimanual examination, 75% (No. = 53) were found to have abnormal findings at laparoscopy; out of 55 patients with abnormal bimanual examination, 11% (No. = 6) were found to have normal laparoscopic findings.(ABSTRACT TRUNCATED AT 250 WORDS)