Diagnostic laparoscopy in chronic pelvic pain.
BACKGROUND
Laparoscopy, because of its availability and safety, provides a valuable tool in the evaluation of undiagnosed chronic pelvic pain. It is a simple and definitive means of establishing the presence or absence of pelvic pathology without resorting to major abdominal surgery.


OBJECTIVE
To evaluate the causes of chronic pelvic pain using laparoscopy and to correlate between clinical examination, ultrasonography, and laparoscopy.


METHODS
The present prospective study was done in the Department of Obstetrics and Gynecology of Pt. BD Sharma, PGIMS Rohtak. Fifty cases of chronic pelvic pain attending gynae OPD were included in the study. After detailed history, examination, investigations, and ultrasonography, the patients were subjected to laparoscopy.


RESULTS
The mean age and parity of the patients with CPP was 30.88 ± 7.71 years and 1.74 ± 1.38, respectively. The mean duration of pain was 2.8 years (6 months-8 years). The commonest finding on laparoscopy was adhesions in 40%, endometriosis in 18%, and pelvic congestion syndrome in 20%, while 10% of the patients had normal pelvis. Laparoscopic findings were taken as gold standard and pelvic examination and ultrasonographic findings were compared with it.


CONCLUSIONS
Clinical examination and ultrasonography has a sensitivity of 8.1 and 2%, respectively. Laparoscopy helps in detecting many causes of CPP which clinical methods and ultrasonography fail to identify. This enforces the position of laparoscopy as a gold standard in evaluation of this condition.
Sharma
Damyanti
D
Department of Obstetrics and Gynecology, Pt. BDS, PGIMS, Rohtak, Haryana, India.
Dahiya
Krishna
K
Duhan
Nirmala
N
Bansal
Ruchi
R
D000328:Adult; D002908:Chronic Disease; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D010535:Laparoscopy; D017699:Pelvic Pain / Q000209:etiology*; D012680:Sensitivity and Specificity; D000267:Tissue Adhesions / Q000150:complications / Q000175:diagnosis; D014463:Ultrasonography