THE ROLE OF LAPAROSCOPY IN THE EVALUATION OF CHRONIC PELVIC PAIN - PITFALLS WITH A NEGATIVE LAPAROSCOPY

Laparoscopic findings are negative in anywhere from 10% to 90% of wome n with chronic pelvic pain. When this occurs a woman is often told one or more of the following: (1) nothing is wrong; (2) the pain is in he r head and she should see a psychiatrist; (3) she should have a neurol ytic procedure, such as uterine nerve transection or presacral neurect omy; (4) the only thing that is left to do is a hysterectomy; or (5) n othing can be done and she must learn to live with the pain. Usually t hese statements are inappropriate, often stemming from the mistaken be lief that laparoscopy represents the definitive diagnostic end point i n the evaluation of a woman with chronic pelvic pain. It is important that gynecologists appreciate that laparoscopy is only one of many pos sible methods of evaluation and recognize ifs diagnostic limitations a nd pitfalls.