Chronic pelvic pain and the role of exploratory laparoscopy as diagnostic and therapeutic tool: a retrospective observational study

Brichant, Géraldine; Tebache, Linda; Poismans, Gaëlle; Pinzauti, Serena; Dechenne, Valérie; Nisolle, Michelle

doi:10.1186/s10397-018-1045-5

Cited by 11 publications

(12 citation statements)

References 24 publications

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“…The commonest surgical intervention was cystectomy (40.7%), this goes with our finding that most of the pathology was ovarian cyst. This disagree with what found by Brichant, G., et al [9] reported performance of cystectomy in (17%) of the patients ,…”

Section: Discussioncontrasting

confidence: 95%

“…)% It is possible that more than one lesion could have been found in a patient and so more than one surgical procedure would then be carried out. [9] In all cases but one, adhesiolysis has been always associated with another surgical procedure. In 66% of the patients undergoing excision of USLs, another procedure was performed.…”

Section: Discussionmentioning

confidence: 99%

“…Chronic pelvic pain (CPP) is defined as constant or intermittent pain lasting since at least for a period of 6 months in the pelvis or the lower abdomen or It can be localized in the pelvis, the anterior abdominal wall at the umbilicus or below, and the lumbosacral back or the buttocks, it can occur only at certain times, such as before or after eating, urination or during sex, and is adequate to cause functional disability or cause seeking for medical management. [1] Nearly 15% of females between 18-49 years old complain of CPP, but less than a 33% seek medical advice [2]. CPP is in charge of around 10% of consultations in gynecology and represents the surgical indication of around 40% of exploratory laparoscopies [ 1 .]…”

Section: Introductionmentioning

confidence: 99%

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The Role of Diagnostic Laparoscopy in Chronic Pelvic Pain

Abid¹,

Al-Karim²,

Rajab³

2023

Al-Kitab J. Pure Sci.

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One of the commonest symptomatology in gynecological outpatient clinics is chronic pelvic pain, it accounts for 10% of gynecologist’s general clinics patients. The study aimed to To evaluate the role of laparoscopy in evaluation of CPP, and its correlation with clinical examination and vaginal ultrasound examination. The present prospective study was done in the Department of Obstetrics and Gynecology Salah Al-Deen general hospital in Tikrit city from 1stApril- 31st August 2020. The study sample consists of 30 patients with chronic pelvic pain, according to the ACOG criteria, with a convenient sampling method. The data collection done through: a designed closed and open-ended questionnaire, physical examination, transvaginal ultrasound & laparoscopic examination for the 30 patients for evaluation of chronic pelvic pain. By laparoscopic examination (90%) of patients had positive findings, pelvic examination identified (89%) of them correctly. Those with negative findings in laparoscopy was (10%) of patient, (33.3%) of them were diagnosed as negative by pelvic examination, there were miss diagnosis in (67%) of the negative patient and (11.1%) of positive diagnosed patient, this was a statically significant relation. Sensitivity of TVS was 85%, versus 89% for the pelvic examination. Specificity for TVS, and pelvic examination was (100%), (33%) respectively. Accuracy of the test for TVS, and pelvic examination was (87%), (83%) respectively. Exploratory laparoscopy provides a definitive diagnosis in 90% of women complaining of unexplained CPP. The surgical treatment of these lesions improves painful symptomatology in 70% of women.

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Section: Discussioncontrasting

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Role of Diagnostic Laparoscopy in Chronic Pelvic Pain

Abid¹,

Al-Karim²,

Rajab³

2023

Al-Kitab J. Pure Sci.

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“…Previous reports have stressed upon the duration, its pattern and the location of pain to describe CPP. 1,2 Howard gave a most satisfactory definition which state that non-menstrual pain which last for at least 3 months of duration, localizes to the anatomic pelvis and its extent that can cause functional disability and require medical or surgical treatment is called CPP. 3 Adhesions describe the connections between opposing serosal and/or nonserosal surfaces of internal organs and the abdominal wall.…”

Section: Introductionmentioning

confidence: 99%

Evaluating degree of pelvic pain and comparing it with the type and degree of adhesions in patients of Endometriosis

Sonwani¹,

Biswas²

2021

IJOGR

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Introduction: Intra-abdominal adhesions are common features of endometriosis. Adhesions lead to several chronic symptoms including abdominal distension, pain, nausea, and abnormal bowel movement pattern. Adhesive disease may be life-altering in many patients. Aims and Objectives: To study types of pain and compare it with type and degree of adhesion. Materials and Methods: Thirty women diagnosed with endometriosis were studied. Pain intensity was assessed by visual analogue scale (VAS) and categorized as mild, moderate or severe accordingly. This was followed by laparoscopy/ laparotomy and staging of endometriosis which was done as per the American Society for Reproductive Medicine (ASRM) classification system. Corrective procedures were done simultaneously. Women were followed-up after 6 weeks to reassess the pain intensity by using the same visual analogue scale (VAS). Results: Mean age of study cohort was 30 ±5.75 years. As per VAS, half of the patients had moderate pain (50%). Forniceal thickening was present in 73.33% and cyst was felt in 66.66% women.76.66% had unilateral cysts. Unilateral tubal adhesions were present in 76.66% women and bilateral adhesions were present in 23.33% women. Among the types of adhesions, flimsy adhesions were most common, being present in 76.66% women and deep adhesions were present in 20% women. Majority had 1/3 rd-2/3 rd tubal adhesions (46.7%). All the ovarian adhesions were flimsy. Obliteration was present in 30% women. Forniceal thickening was reported in majority of the women with moderate pain (93.3%) (p=0.001). Cyst was felt on per-vaginum examination in 80% women with severe pain. The correlation of degree of ovarian adhesions (p=0.003) and type and degree of tubal adhesions (p=0.004) with degree of pain by VAS in endometriosis was significant. Conclusion: We found significant association between severity of pain and type of adhesions and between degree of tubal and ovarian adhesions and severity of pain. Operative procedures decrease the severity of pain.

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“…Typically, multifactorial, chronic pelvic pain (CPP) is a common complaint in woman of childbearing age. In such case, laparoscopy as a diagnostic tool, allows also to treat certain pathologies related to CPP, like endometriosis (presence of uterine endometrial tissue outside of the normal location) [1]. Complete surgical excision of endometriosis has been proved as an effective treatment to relieve pain and improve quality of life [2].…”

Section: Introductionmentioning

confidence: 99%