Laparoscopic treatment of chronic pelvic pain in 100 adult women.
OBJECTIVE
To evaluate the effectiveness of laparoscopic surgical treatment for women with chronic pelvic pain.


METHODS
Prospective evaluation of women treated consecutively between January 1, 1989, and December 31, 1992.


METHODS
A private practice.


METHODS
One hundred women with chronic pelvic pain.


METHODS
Laparoscopic treatment was performed in all patients. Pain level was rated on a scale of 1 to 10 (1 = no pain, 10 = severe, disabling pain). Patients recorded their pain levels before and 1 month, 3 months, and 6 months after surgery, as well as at intervals of 1, 2, and 3 years after surgery.


RESULTS
Preoperatively, the average pain level reported by the patients was 8.2. At 1 month after laparoscopic surgical therapy, it had dropped to 3.6, at 6 months to 1.9, and at 3 years to 2.2. Twenty patients reported pain levels of 5 or greater at the 6-month interval. Six of them proceeded to hysterectomy, and four of these six were found to have adenomyosis. Eleven of the 100 who had pain levels greater than 5 after initial procedure had no further therapy, and 3 underwent repeat laparoscopy.


CONCLUSIONS
Extensive laparoscopic surgery to restore normal pelvic anatomy and remove all diseased tissue, including treatment of all endometriosis, resection of ovarian cysts, resection of adhesions, removal of the appendix, and treatment of hernias when indicated, together with laparoscopic uterosacral nerve vaporization or presacral neurectomy, results in significant improvement in reported pain levels.
Carter
J E
JE
Department of Obstetrics and Gynecology, University of California Irvine, College of Medicine, Irvine, California, USA.
D000293:Adolescent; D000328:Adult; D001062:Appendectomy; D002908:Chronic Disease; D004715:Endometriosis / Q000601:surgery; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D007001:Hypogastric Plexus / Q000601:surgery; D007044:Hysterectomy; D010535:Laparoscopy; D007889:Leiomyoma / Q000601:surgery; D008160:Lumbosacral Plexus / Q000601:surgery; D008875:Middle Aged; D010048:Ovarian Cysts / Q000601:surgery; D010147:Pain Measurement; D017699:Pelvic Pain / Q000601:surgery*; D011446:Prospective Studies; D012086:Reoperation; D000267:Tissue Adhesions / Q000601:surgery; D014591:Uterine Diseases / Q000601:surgery; D014594:Uterine Neoplasms / Q000601:surgery; D014599:Uterus / Q000294:innervation