title: Laparoscopic plication and suspension of the round ligament for chronic pelvic pain and dyspareunia.
abstract: 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.
authors.affiliation: Mesa Koru Sitesi Manolya Blok, 24, Cayyolu, 06530, Ankara, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Batioglu
authors.forename: H B
authors.initials: HB
authors.lastname: Zeyneloglu
mesh_terms: 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