title: How can we reduce negative laparoscopies for pelvic pain?
abstract: Chronic pelvic pain is a common condition and the RCOG guideline provides an evidence-based framework for the initial assessment. This study investigated the adequacy and relevance of the initial assessment in patients who underwent elective laparoscopic procedure for pelvic pain. History-taking was found to be deficient and was unable to identify factors which may be related to the cause or perception of the pain. Only a small percentage benefitted from a therapeutic trial of hormonal and non-hormonal agents and referral to other specialities. Ultrasound and bimanual examination were both found to be of little value. Laparoscopy assisted in diagnosis in 45% of patients. A structured initial assessment and targeted selection of patients for laparoscopy would reduce the number of patients with normal findings and thus, it would reduce the number of women who suffer pain and isolation after a negative laparoscopy.
authors.affiliation: Department of Obstetrics and Gynaecology, James Paget University Hospital NHS Foundation Trust, Great Yarmouth, UK. nilanjanasingh@yahoo.co.uk
authors.forename: N
authors.initials: N
authors.lastname: Singh
authors.forename: M
authors.initials: M
authors.lastname: Rashid
authors.forename: R P
authors.initials: RP
authors.lastname: Herath
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D019317:Evidence-Based Medicine; D005260:Female; D006728:Hormones / Q000627:therapeutic use; D006801:Humans; D010535:Laparoscopy; D008485:Medical Audit; D008875:Middle Aged; D017699:Pelvic Pain / Q000175:diagnosis* / Q000188:drug therapy; D012189:Retrospective Studies; D019564:Unnecessary Procedures; D055815:Young Adult
chemical_list: D006728:Hormones