The role of laparoscopy as a diagnostic tool in chronic pelvic pain.
More than 40% of laparoscopies are performed for the diagnosis of chronic pelvic pain (CPP). Although laparoscopic evaluation is sometimes considered a routine part of the evaluation, ideally the decision to perform a laparoscopy should be based on the patient's history, physical examination and findings of non-invasive tests. About 65% of women with CPP have at least one diagnosis detectable by laparoscopy and it is common to attribute causality to this diagnosis. Endometriosis is diagnosed in one-third of laparoscopies for CPP. Endometriosis requires histological confirmation to assure an accurate diagnosis. Adhesions are diagnosed in about one-quarter of laparoscopies. Ovarian cysts, hernias, pelvic congestion syndrome, ovarian remnant syndrome, ovarian retention syndrome, post-operative peritoneal cysts and endosalpingiosis are other diagnoses that can be made laparoscopically in some cases. Laparoscopic conscious pain mapping has the potential to improve the accuracy of laparoscopy as a diagnostic tool in CPP.
Howard
F M
FM
University of Rochester School of Medicine and Dentistry, Rochester General Hospital, New York 14621, USA.
D002908:Chronic Disease; D016292:Procedural Sedation; D003937:Diagnosis, Differential; D004715:Endometriosis / Q000150:complications / Q000175:diagnosis; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D010048:Ovarian Cysts / Q000150:complications / Q000175:diagnosis; D010147:Pain Measurement / Q000379:methods*; D017699:Pelvic Pain / Q000209:etiology*; D000267:Tissue Adhesions / Q000150:complications / Q000175:diagnosis