title: Bilateral oophorectomy and hysterectomy in the treatment of intractable pelvic pain associated with pelvic congestion.
abstract: OBJECTIVE
  To determine whether bilateral oophorectomy combined with hysterectomy is an effective treatment for chronic pelvic pain due to congestion.
  
  
  METHODS
  Prospective non-randomized single centre study.
  
  
  METHODS
  Tertiary referral centre to a specialist pelvic pain clinic in a teaching hospital.
  
  
  METHODS
  36 women, 33 of whom had failed to obtain long term relief of pain on medical therapy.
  
  
  METHODS
  Relief of pain, coital frequency, and effect on daily life. Histology of uterus and ovaries.
  
  
  RESULTS
  Median pain score on visual analogue scale fell from a pre-operative value of 10 to 0 at one year. Twelve of the 36 women had some residual pain at one year postoperatively, but in only one woman was the pain affecting her daily life. Thirty women were noted to have pelvic tenderness pre-operatively, at one year, 26 had no tenderness and four minimal tenderness on pelvic examination. The median frequency of sexual intercourse increased from once per month preoperatively to eight times per month one year postoperatively. The uterus was histologically normal in 25 women, adenomyosis was present in eight of whom two had ovarian endometriosis. Fibroids were present in three and endometriosis was found confined to the ovaries in one woman. Multiple peripheral cysts were present in the ovaries of 25 women.
  
  
  CONCLUSIONS
  Bilateral oophorectomy combined with hysterectomy and hormone replacement therapy is an effective treatment for chronic pelvic pain due to venous congestion, which has failed to respond to medical treatment and leads to restoration of normal coital function and daily life.
authors.affiliation: Department of Obstetrics and Gynaecology, St Mary's Hospital Medical School, London.
authors.forename: R W
authors.initials: RW
authors.lastname: Beard
authors.forename: R G
authors.initials: RG
authors.lastname: Kennedy
authors.forename: K F
authors.initials: KF
authors.lastname: Gangar
authors.forename: R W
authors.initials: RW
authors.lastname: Stones
authors.forename: V
authors.initials: V
authors.lastname: Rogers
authors.forename: P W
authors.initials: PW
authors.lastname: Reginald
authors.forename: M
authors.initials: M
authors.lastname: Anderson
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D003075:Coitus; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D010052:Ovariectomy; D010053:Ovary / Q000473:pathology; D010147:Pain Measurement; D010148:Intractable Pain / Q000473:pathology / Q000601:surgery*; D010388:Pelvis / Q000098:blood supply*; D011184:Postoperative Period; D011446:Prospective Studies; D014599:Uterus / Q000473:pathology; D014648:Varicose Veins / Q000473:pathology / Q000601:surgery*