EVALUATE THE DEGREE OF CHRONIC PELVIC PAIN AND DEGREE OF ADHESION: A CLINICO-OBSERVATIONAL STUDY.

Author(s):  
Sweety Rani ◽  
Abha Rani Sinha

Aim: To evaluate degree of chronic pelvic pain and degree of adhesion. Materials and Methods: The present clinico-observational study was conducted in the Department of Obstetrics and Gynecology, Patna Medical College and Hospital, Patna, from December 2016 to December 2017.among 40 women diagnosed with endometriosis. Pain intensity was assessed by visual analogue scale (VAS) and categorized as mild, moderate or severe accordingly. This was followed by laparoscopy/ laparotomy and staging of endometriosis which was done as per the American Society for Reproductive Medicine (ASRM) classification system. Corrective procedures were done simultaneously. Results: Mean age of study cohort was 30 ±5.75 years. As per VAS, majority felt moderate pain (47.5%) in present study. The presenting symptoms were dysmenorrhoea (45.0%), dyspareunia (17.5%) and chronic pelvic pain (35.5%). Conclusion: Degree of tubal involvement was more in all the women as compared to ovarian involvement. Post-operatively the intensity of the pain subsides. Keywords:  VAS, Adhesion, Endometriosis, Tubal, Ovarian

2021 ◽  
pp. 1-3
Author(s):  
Supriya Kumari ◽  
Surya Narayan ◽  
Kumudini Jha ◽  
Debarshi Jana

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.


Author(s):  
Tarini Sonwani ◽  
Ratna Biswas

Background: Endometriosis is considered as the chronic benign gynecologic disease which can cause chronic pelvic pain (CPP) and infertility. Endometriosis has affected almost 10% of the women of reproductive age.Methods: Thirty women diagnosed with endometriosis were studied. Pain intensity was assessed by visual analogue scale (VAS) and categorized as mild, moderate or severe accordingly. This was followed by laparoscopy/ laparotomy and staging of endometriosis which was done as per the American Society for Reproductive Medicine (ASRM) classification system. Corrective procedures were done simultaneously.Results: Mean age of women with endometriosis was 30±5.75 years. Majority had superficial implants (30%), 6.66% had deep implants and 6.66% had combination of superficial and deep implants. There was no significant difference between implants and severity of pain (p=0.069). There was a significant association between severity of pain with obliteration of POD. Significant association was seen between deeply infiltrating endometriosis (DIE) represented by the pouch of Douglas (POD) obliteration and severity of pain.Conclusions: Severity of pain was significantly associated with deeply infiltrating endometriosis (DIE) represented by the pouch of Douglas (POD) obliteration. However, no association was obtained between severities of pain with superficial implants.


2013 ◽  
Vol 1 (2) ◽  
pp. 100-102
Author(s):  
J Bajracharya ◽  
NS Shrestha ◽  
C Karki ◽  
R Saha

Background: Chronic pelvic pain is a common problem in reproductive age group women. Diagnosis of chronic pelvic pain needs multidisciplinary approach. Diagnostic laparoscopy is one of the investigations which can help in reaching the diagnosis. Objective: To know the etiology in chronic pelvic pain. Methods: This was a descriptive study done in the Department of Obstetrics and Gynaecology of Kathmandu medical college teaching hospital from January 2010 to June 2012 (30 months). All the cases of laparoscopic surgery done for chronic pelvic pain were noted and details of these cases were analyzed regarding age, parity and laparoscopic findings. Results: Total 48 cases of Chronic Pelvic Pain underwent diagnostic laparoscopy during the study period. Mean age of cases were 33 years, ranging from 20-46yrs. Almost half of the cases 43.75% were of parity two. Laparoscopic finding was negative in 29.17% and pelvic pathology was present in 70.83% of the cases. Out of the pelvic pathology endometriosis was present in 55.88% followed by pelvic adhesions, pelvic congestion and pelvic inflammatory disease, chronic ectopic in 20.58%, 14.70%, 5.88%, 2.94% respectively. Conclusion: Diagnostic laparoscopy is a useful modality in the diagnosis of etiology and management of Chronic pelvic pain. In our study, Pelvic endometriosis was the most common pelvic pathology in cases of Chronic pelvic pain. DOI: http://dx.doi.org/10.3126/jkmc.v1i2.8146 Journal of Kathmandu Medical College, Vol. 1, No. 2, Oct.-Dec., 2012: 100-102


2020 ◽  
Author(s):  
Elham Kor ◽  
Seyed Reza Saadat Mostafavi ◽  
Zahra Ahmadian Mazhin ◽  
Adeleh Dadkhah ◽  
Anis Kor ◽  
...  

Abstract Objectives: About 10-15% of women of childbearing age have endometriosis. The present study aimed to investigate the relationship between the severity of symptoms of endometriosis and the spread as well as the stage of the disease on ultrasonography. The present cross-sectional study evaluates the relationship between the severity of endometriosis symptoms and the spread of disease on ultrasonography in patients with endometriosis.Results: Considering different analyses, the cumulative size of posterior Deep Infiltrative Endometriosis (DIE) (less than 1 cm) is significantly correlated with minimal severity of dyspareunia and chronic pelvic pain. The incidence of dyspareunia was more prevalent in patients with complete stenosis of Douglas pouch than those with incomplete stenosis. Furthermore, the incidence of severe and very severe pain in patients with Douglas pouch stenosis is relatively higher than that in patients without stenosis. Only dyspareunia is related to the stage of endometriosis, and patients with dyspareunia are five times more at risk of a higher stage of the disease. The severity of dyspareunia is related to the stage of endometriosis and the severity of Douglas pouch stenosis. The results showed a correlation between chronic pelvic pain and r-ASRM score (revised American Society for Reproductive Medicine score).


1970 ◽  
Vol 21 (2) ◽  
pp. 118-120
Author(s):  
Hasina Akhtar ◽  
Ziban Nahar

A 12-month study was carried out on 500 patients attending between January 2006 to December 2006 in a private chamber in Rajshahi and outpatient Department of Gynecology and Obstetrics of Rajshahi Medical College. The aim of the study was to assess the frequency of chronic pelvic pain and cause of chronic pelvic pain among the patients attending there. Among the 500 recruited patients 20% had organic cause; the rest 80% had no organic cause. Among the recruited patient, only 20% underwent surgery & improved after surgery. It was also found that another 60% improved with medical treatment, psychotherapy and counseling. doi: 10.3329/taj.v21i2.3789 TAJ 2008; 21(2): 118-120


2020 ◽  
pp. 1-2
Author(s):  
Priya Saxena ◽  
Bharti Maheshwari ◽  
Debarshi Jana

Background/purpose: The purpose of the present study was to evaluate the role of laparoscopy in diagnosis the cases of chronic pelvic pain. Methods: This prospective study was conducted among 100 women who had been suffering from chronic pelvic pain for ≥6 months at Department of Obstetrics & gynaecology, Muzaffarnagar Medical College, Muzaffarnagar from December 2017 to December 2018. After proper selection of cases, a detailed history followed by general, systemic and pelvic examination, diagnostic laparoscopy of the patient was done and noted as per the following protocol. Diagnostic laparoscopy was performed under general anaesthesia using a 5-mm Karl Stortz 30° angle double port laparoscope. The data was collected and subjected to statistical analysis using SPSS version 22.00 Results: Majority (70%) of patients with CPP were in the age group between 26 – 30 years and 31 – 35 years. Two most common causes of CPP detected clinically were endometriosis and chronic PID which together constituted about 56% of the cases with CPP in our study group. Laparoscopy findings revealed that 90% of patients with CPP have one or more positive findings, the commonest being endometriosis in various pelvic sites with or without endometrioma (34%) Conclusion: It can be concluded that ideally hysteroscopy should be performed simultaneously to identify intrauterine pathologies, which can be associated with CPP and which are missed by laparoscopy. Hence combined laparohysteroscopy is the ideal method for diagnosis of CPP.


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