LAPAROSCOPIC EVALUATION AND TREATMENT OF WOMEN WITH CHRONIC PELVIC PAIN

Study Objective. To evaluate the effectiveness of operative laparoscop ic treatment at the time of diagnostic laparoscopy in patients with ch ronic pelvic pain (CPP). Design. A retrospective study of women with C PP and at least 6 months of follow-up after laparoscopic evaluation an d treatment. Setting. A faculty practice and community teaching hospit al. Patients. A series of 65 consecutive women with greater than 1 mon th of pelvic pain who underwent laparoscopy. Thirty-two were referred by other physicians for evaluation of CPP. Interventions. Patients had operative laparoscopic treatment of all abnormal findings at the time of diagnostic laparoscopy. Nonspecific treatment such as presacral ne urectomy or uterine nerve ablation was not performed. Measurements and Main Results. After laparoscopic evaluation and treatment, 78% of pat ients had decreased pain and 45% were pain free. Prior unsuccessful me dical or surgical treatment did not affect the response rate. Endometr iosis and adhesive disease were the most common diagnoses, 38% and 34% , respectively. Conclusions. Laparoscopic surgical treatment of pathol ogy noted at the time of diagnostic laparoscopy in women with CPP is a ppropriate, but less than one-half of patients may be expected to have complete pain relief.