Laparoscopic evaluation of chronic pelvic pain after total abdominal hysterectomy

Total abdominal hysterectomy is a quite common open surgical operation accounting for 54% of all benign diseases. Indications are uterine fibroids, adenomyosis/endometriosis, AUB, chronic pelvic pain, cancer of ovaries, uterus or cervix or cancer phobia. It is relatively an uncomplicated operation and easiest when least required.

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Pelvic congestion syndrome

Mediscope ◽

10.3329/mediscope.v1i1.21635 ◽

2015 ◽

Vol 1 (1) ◽

pp. 33-35

Author(s):

Razia Sultana ◽

Rowshan Ara Begum ◽

Ferdousi Begum

Keyword(s):

Pelvic Pain ◽

Chronic Pelvic Pain ◽

Premenopausal Women ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Standing Position ◽

Pelvic Congestion Syndrome ◽

History Of ◽

One Year ◽

Pelvic Congestion

Chronic pelvic pain is a common gynecological problem with many causes and may account for approximately 10% outpatient gynecological visit. Pelvic Congestion Syndrome (PCS) is defined as a condition characterized by congestion of the pelvic veins visible on selective ovarian venography in multiparous premenopausal women with a history of chronic pelvic pain for more than six months. We report a case of PCS in 35 years old multiparous lady complaining of chronic pelvic pain for one year. The pain was worsened by sitting and standing position. Other general symptoms were present such as dysmenorrhea, rectal discomfort and urinary frequency. On examination patient was depressed, there was abdominal and pelvic tenderness. Pelvic ultrasound and Doppler examination showed dilated and tortuous ovarian veins and dilated tortuous arcuate veins in the myometrium. An ovarian cyst was present and uterus was enlarged. In this case total abdominal hysterectomy was done although ideal treatment for PCS is ovarian vein embolisation by interventional radiology which is not available in our country. DOI: http://dx.doi.org/10.3329/mediscope.v1i1.21635 Mediscope Vol. 1, No. 1: 2014, Pages 33-35

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Prevalence of Histologic Endometriosis in Clinically-Negative Peritoneum in Patients Undergoing Laparoscopic Evaluation for Chronic Pelvic Pain

Journal of Minimally Invasive Gynecology ◽

10.1016/j.jmig.2017.08.370 ◽

2017 ◽

Vol 24 (7) ◽

pp. S115

Author(s):

A. Gubbels ◽

N. Mehandru ◽

M. Castellanos ◽

N. Desai ◽

M. Hibner

Keyword(s):

Pelvic Pain ◽

Chronic Pelvic Pain ◽

Laparoscopic Evaluation

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Laparoscopic evaluation of infertile patients with chronic pelvic pain

Reproductive BioMedicine Online ◽

10.1016/s1472-6483(10)61008-5 ◽

2006 ◽

Vol 12 (3) ◽

pp. 347-353 ◽

Cited By ~ 10

Author(s):

Spyros Milingos ◽

Athanasios Protopapas ◽

George Kallipolitis ◽

Petros Drakakis ◽

Antonios Makrigiannakis ◽

...

Keyword(s):

Pelvic Pain ◽

Chronic Pelvic Pain ◽

Laparoscopic Evaluation ◽

Infertile Patients

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A PROSPECTIVE CROSS SECTIONAL OBSERVATIONAL STUDY OF CHRONIC PELVIC PAIN IN ADOLESCENTS TRANSVAGINAL ULTRASOUND VERSUS LAPAROSCOPY

10.36106/ijsr/7332917 ◽

2021 ◽

pp. 1-3

Author(s):

Supriya Kumari ◽

Surya Narayan ◽

Kumudini Jha ◽

Debarshi Jana

Keyword(s):

Observational Study ◽

Pelvic Pain ◽

Chronic Pelvic Pain ◽

Transvaginal Ultrasound ◽

Cross Sectional ◽

Predictive Values ◽

Medical College ◽

Kappa Test ◽

Laparoscopic Evaluation ◽

Good Agreement

Background: Chronic pelvic pain (CPP)is cyclic or noncyclic, intermittent or constant discomfort in the pelvic region for at least 6 months. It is a common complaint in female adolescents that may be overlooked. Objective: To evaluate CPP in adolescents using transvaginal ultrasound (TVS) and laparoscopy. Study design: This is a prospective cross sectional observational study conducted at Obstetrics and Gynaecology Department of Darbhanga Medical College and Hospital, Laheriasarai, Bihar. A total of 100 adolescents with CPP were evaluated by TVS and laparoscopy and findings were analyzed. Results: The mean age of adolescents was 17 ± 3.5 the majority were parous (51%), rural (69%) and low social class (65 %). Diffuse pelvic pain was present in (62%), Dysmenorrheain (61%), deep abdominal and pelvic tenderness in (55% and 80% respectively). TVS was normal in (40%) andabnormalin (60%). Laparoscopic evaluation was normal in (29%)and abnormal in(71%) in the form of tubo- ovarian masses (19%),endometriosis (18%) ovarian cysts (9%), adenomyosis (8%), Adhesions (6%), PID and RVF uterus (4% for each), subserous fibroid and pelvic congestion (1% for each). sensitivity and specificity of TVS were (81.7% and 93.1% respectively). Positive and negative predictive values were 96.7% and 67.5% respectively. Kappa test between TVS and laparoscopy showed good agreement (kappa = 0.67). Conclusions: Good agreement was found between TVS and laparoscopy, however, laparoscopy is considered as a gold standard tool in evaluating adolescent CPP because of distinct advantages in terms of sensitivity and negative predictive value.

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LAPAROSCOPIC EVALUATION OF CHRONIC PELVIC PAIN IN WOMEN: ITS PRESENT ROLE AND ADVANTAGE OVER OTHER DIAGNOSTIC PROCEDURES

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2016/128 ◽

2016 ◽

Vol 5 (13) ◽

pp. 560-563

Author(s):

Surajeet Boruah ◽

Pranay Phukan

Keyword(s):

Pelvic Pain ◽

Chronic Pelvic Pain ◽

Diagnostic Procedures ◽

Laparoscopic Evaluation ◽

Present Role

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Risk Factors for Chronic Pain after Hysterectomy

Anesthesiology ◽

10.1097/01.anes.0000265161.39932.e8 ◽

2007 ◽

Vol 106 (5) ◽

pp. 1003-1012 ◽

Cited By ~ 144

Author(s):

Birgitte Brandsborg ◽

Lone Nikolajsen ◽

Charlotte T. Hansen ◽

Henrik Kehlet ◽

Troels S. Jensen

Keyword(s):

Risk Factors ◽

Chronic Pain ◽

Spinal Anesthesia ◽

Pelvic Pain ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Indication For Surgery ◽

Postsurgical Pain ◽

Chronic Postsurgical Pain ◽

Previous Cesarean

Background Women scheduled to undergo hysterectomy for benign indications frequently have preoperative pelvic pain, but it is largely unknown why pain in some cases persists or even develops after surgery. This nationwide questionnaire and database study describes pain and identifies risk factors for chronic postsurgical pain 1 yr after hysterectomy for benign indications. Methods A pain questionnaire was mailed to 1,299 women 1 yr after hysterectomy. The response rate was 90.3%, and the presence of persistent pain was correlated to indication for surgery, surgical procedure, type of anesthesia, and other perioperative data. Results Pain was reported by 31.9% 1 yr after hysterectomy (chronic pain), and 13.7% had pain more than 2 days a week. Pain was not present before surgery in 14.9% of women with chronic postsurgical pain. Risk factors for chronic pain were preoperative pelvic pain (odds ratio [OR], 3.25; 95% confidence interval [CI], 2.40-4.41), previous cesarean delivery (OR, 1.54; CI, 1.06-2.26), pain as the main indication for surgery (OR, 2.98; CI, 1.54-5.77), and pain problems elsewhere (OR, 3.19; CI, 2.29-4.44). Vaginal hysterectomy versus total abdominal hysterectomy was not significantly associated with a lower risk of chronic pain (OR, 0.70; CI, 0.46-1.06). Importantly, spinal versus general anesthesia was associated with less chronic pain (OR, 0.42; CI, 0.21-0.85). Conclusions Thirty-two percent had chronic pain after hysterectomy, and risk factors were comparable to those seen in other operations. Interestingly, spinal anesthesia was associated with a lower frequency of chronic pain, justifying prospective study of spinal anesthesia for patients with a high risk for development of chronic postsurgical pain.

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