Etiological Diagnosis of Chronic Pelvic Pain in Patients Submitted to Laparoscopic Surgery

Andréa Prestes Nácul, Sergio Galbinski, Gyana Antoni, Lutero Jung
2008 · W2182211776
OA: closed CC0 Metadata only
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This study identified endometriosis in 58.3% of female patients undergoing laparoscopy for chronic pelvic pain, with pain severity not correlating to disease stage.

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Abstract

Objective: The goal of this study was to identify the etiological diagnosis of CPP and profile of patients submitted to laparoscopic surgery in a public hospital. Patients and Methods: the research to place at the Division of Laparoscopic Surgery of Hospital Femina at Porto Alegre – Brazil from September 2006 to August 2007. The study population included female patients submitted to laparoscopy for Chronic Pelvic Pain (CPP) from September 2006 to August 2007. The study evaluated the laparoscopic surgery results for CPP, the anathomo-pathological exams and the CPP protocol filled up during appointments before laparoscopy. Results: Thirty-six patients were submitted to laparoscopy. Fifty percent of the patients reported cyclical pain and ninety five percent of the patients had dysmenorrheal and dyspareunia complaint. History of Sexually Transmitted Disease (STD) or PID was present in 43% and 48% of the cases, respectively. The most common contraceptive method used was oral contraceptive by 55,6% of the patients, followed by tubal ligation and condoms , both with 11% rate. Anamnesis revealed 8,3% of obesity, 22% of tobacco users and 6% suffer from depression. Almost half of the patients revealed familial history of endometriosis (47%), wherein 37% of patients with endometriosis diagnosis from laparoscopy had a positive familial history of the disease. Physical examination revealed abdominal scar in 53% of the patients, pain during palpation in 67%, and pain at uterine cervix mobilization in 80%. At laparoscopy we observed high prevalence of endometriosis as a cause of Chronic Pelvic Pain (58,3%). From all patients with endometriosis diagnosis, 50% were classified as stage I, and 50% as stage IV. Discussion: More than a half of the patients with CPP presented endometriosis diagnosis. We observed an expressive percentage of patients with mild endometriosis. In these cases pain could be justified by the production of local inflammatory factors in atypical lesions that are active biologically. In accordance with the literature there is no correlation between pain due to endometriosis and the stage of the disease.

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Condition tags

endometriosischronic_pelvic_paindyspareunia

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