Laparoscopic plication and suspension of the round ligament for chronic pelvic pain and dyspareunia.
OBJECTIVE
To describe a technique of uterine suspension using round ligaments to relieve pain in selected patients with various degrees of uterine retroversion.


METHODS
Prospective clinical study (Canadian Task Force classification II-2).


METHODS
University-based center for reproductive medicine.


METHODS
Thirty women who underwent laparoscopy for investigation of chronic pelvic pain (CPP) and dyspareunia.


METHODS
Round ligaments were plicated using a modification of intracorporeal knot tying during laparoscopy.


RESULTS
The extent of plication was planned to elevate the uterus and bring it minimally forward. Mean +/- SD operating time was 14+/-4 minutes. Pain scores before and after surgery were 4.5+/-1.0 and 1.6+/-0.6, respectively (p<0.001). There were no complications during or after surgery. Only three women had minimal dyspareunia postoperatively, although they had anteverted uteri. One patient had severe dyspareunia that developed 7 months after surgery and continued through the second year of follow-up. Nineteen women with anteverted uteri were free of dyspareunia after 2 years.


CONCLUSIONS
Round ligament plication is safe and effective in patients with retroverted uteri and dyspareunia or CPP.
Batioglu
S
S
Mesa Koru Sitesi Manolya Blok, 24, Cayyolu, 06530, Ankara, Turkey.
Zeyneloglu
H B
HB
D000328:Adult; D002908:Chronic Disease; D004414:Dyspareunia / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D017699:Pelvic Pain / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D011446:Prospective Studies; D012404:Round Ligament of Uterus / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome