title: Effect of tubal ligation on pelvic endometriosis externa in multiparous women with chronic pelvic pain.
abstract: OBJECTIVE
  To determine whether tubal ligation is associated with decreased prevalence and less severity of pelvic endometriosis in multiparous patients with chronic pelvic pain.
  
  
  METHODS
  From January 1995 to April 2002, 322 chronic pelvic pain patients underwent laparoscopy. Of these, 125 patients were multiparous (parity > or = 2). Their obstetric history, present contraceptive methods and laparoscopic findings were recorded perioperatively. The medical record of each patient was reviewed and analyzed.
  
  
  RESULTS
  Among multiparous women with chronic pelvic pain, the prevalence of endometriosis in patients with and without tubal ligation was 45.1% (23 of 51 patients) and 59.5% (44 of 74 patients), respectively. Moderate-severe endometriosis was found in 8.7% (2 of 23 patients) and 36.4% (16 of 44 patients) among patients with and without sterilization. Tubal ligation was statistically significantly associated with severity of disease [P = 0.036, Crude OR (95% CI) = 0.17 (0.02-0.85), Adjusted OR (95% CI) = 0.21 (0.04-1.08)]. There was no statistically significant relationship between tubal ligation and prevalence of endometriosis. The small sample size of the study might account for this statistical result.
  
  
  CONCLUSIONS
  Nearly half of multiparous women with chronic pelvic pain and tubal ligation had endometriosis. Tubal ligation was related to less severity of disease, with statistically significant difference.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand. csophon@medicine.psu.ac.th
authors.forename: Sopon
authors.initials: S
authors.lastname: Cheewadhanaraks
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003268:Contraception Behavior; D004715:Endometriosis / Q000150:complications / Q000517:prevention & control*; D005260:Female; D006801:Humans; D016015:Logistic Models; D010298:Parity; D017699:Pelvic Pain / Q000209:etiology* / Q000517:prevention & control; D013246:Sterilization, Tubal