Laparoscopic adhesiolysis and relief of chronic pelvic pain.
OBJECTIVE
To evaluate the short- and long-term results of laparoscopic enterolysis in patients with chronic pelvic pain following hysterectomy.


METHODS
Forty-eight patients were evaluated at time intervals from 2 weeks to 5 years after laparoscopic enterolysis. Patients were asked to rate postoperative relief of their pelvic pain as complete/near complete relief (80-100% pain relief), significant relief (50-80% pain relief), or less than 50% or no pain relief.


RESULTS
We found that after 2 to 8 weeks, 39% of patients reported complete/near complete pain relief, 33% reported significant pain relief, and 28% reported less than 50% or no pain relief. Six months to one year postlaparoscopy, 49% of patients reported complete/near complete pain relief, 15% reported significant pain relief, and 36% reported less than 50% or no pain relief. Two to five years after laparoscopic enterolysis, 37% of patients reported complete/near complete pain relief, 30% reported significant pain relief, and 33% reported less than 50% or no pain relief. Some patients required between 1 and 3 subsequent laparoscopic adhesiolysis. A total of 3 enterotomies and 2 cystotomies occurred, all of which were repaired laparoscopically.


CONCLUSIONS
We conclude that laparoscopic enterolysis may offer significant long-term relief of chronic pelvic pain in some patients.
Nezhat
F R
FR
Deaprtment of Gyn/OB, Stanford University School of Medicine, CA, USA.
Crystal
R A
RA
Nezhat
C H
CH
Nezhat
C R
CR
D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D010535:Laparoscopy; D008875:Middle Aged; D010147:Pain Measurement; D017699:Pelvic Pain / Q000209:etiology* / Q000601:surgery*; D011795:Surveys and Questionnaires; D000267:Tissue Adhesions / Q000150:complications* / Q000601:surgery*; D016896:Treatment Outcome