Prospective randomized trial of right-sided paracolic adhesiolysis for chronic pelvic pain.
BACKGROUND
Prior study has shown that right paracolic adhesions are found in 90% of patients with chronic pelvic pain and less frequently in pain-free patients. We set out to determine whether paracolic adhesiolysis will reduce site-specific pain.


METHODS
This was a prospective, randomized trial of right paracolic adhesiolysis at the time of diagnostic and operative laparoscopy for chronic pelvic pain. Twenty-five patients with a diagnosis of chronic pelvic pain were randomized to either undergo or withhold lysis of right paracolic adhesions at the time of operative laparoscopy.


RESULTS
Right paracolic adhesions were found in 100% of our patients. For all subjects, there was a significant reduction of right and left lower quadrant pain (P<0.001) following the operative laparoscopy. Those who underwent right paracolic adhesiolysis had significantly greater right pelvic pain reduction than those who did not (P=0.014). There was no difference in the reduction of left or mid pelvic pain between the treatment and control groups.


CONCLUSIONS
Right paracolic adhesiolysis reduces short-term site-specific tenderness in patients with chronic pelvic pain. Patients who would benefit from diagnostic or operative laparoscopy are likely to benefit further from paracolic adhesiolysis.
Keltz
Martin D
MD
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, St. Luke's-Roosevelt Hospital Center, Columbia College of Physicians and Surgeons, New York, New York 10019, USA.
Gera
Puja Sharma
PS
Olive
David L
DL
D000328:Adult; D002908:Chronic Disease; D004715:Endometriosis / Q000150:complications / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D010147:Pain Measurement; D000292:Pelvic Inflammatory Disease / Q000150:complications / Q000601:surgery; D017699:Pelvic Pain / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D000267:Tissue Adhesions / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome