Laparoscopic Outcomes after Normal Clinical and Ultrasound Findings in Young Women with Chronic Pelvic Pain: A Cross-Sectional Study

Abstract

Chronic pelvic pain (CPP) is one of the most common chronic pain problems experienced by women, with prevalence rates comparable to asthma and back pain. However, it is poorly understood and causative pathology is only seldom found. We aimed to establish prevalence of abnormal findings at diagnostic laparoscopy in young women with CPP after normal findings at clinical examination and pelvic ultrasound scan. Information was retrospectively collected on all laparoscopies undertaken on women aged 16–30 years with normal preoperative findings over a 24-month period. One-hundred-and-fifty women (mean age 25 years and BMI 24.5) were included with laparoscopic examination revealing normal anatomy in 110 (73.3%) and pathology in 40 (27.2%). Endometriosis was detected in 30 (20%); 25 (16.7%) stage 1, 2 (1.3%) stage 2, 2 (1.3%) stage 3 and 1 (0.7%) stage 4. Most laparoscopies carried out on young women with CPP and normal clinical examination and pelvic ultrasound scan showed no significant clinical stigmata of pelvic disease. Women should be fully informed of the multifactorial nature of CPP and there should be a comprehensive management pathway for these women, as proceeding with invasive laparoscopy does not provide additional benefit when investigating CPP in the context of risk, cost and effect on long-term wellbeing.

Association of endometriosis with asthma: a study of the NHANES database in 1999–2006

“…At present, evidences on the relationship between endometriosis and asthma in women are limited and inconsistent. Tempest et al [25] retrospectively collected information on females aged 16-30 years from the Liverpool Women's Hospital, finding that women with endometriosis who underwent laparoscopy were observed to have higher odds of asthma than women without endometriosis. Similarly, in the present study, we found a positive association between endometriosis and asthma in a representative population of the U.S., after adjusting for relevant covariates.…”

Evaluation of the Diagnostic Accuracy of the Interview and Physical Examination in the Diagnosis of Endometriosis as the Cause of Chronic Pelvic Pain

“…Tempest et al diagnosed endometriosis in 20% patient with CPP. In their study, most of laparoscopies carried out on young women with CPP showed no significant clinical stigmata of pelvic pain [ 22 ]. The nature of the pain seems to be of greater importance.…”

Symptomatology and Serum Nuclear Magnetic Resonance Metabolomics; Do They Predict Endometriosis in Fertile Women Undergoing Laparoscopic Sterilisation? A Prospective Cross-sectional Study

“…In symptomatic women, previously reported incidence of endometriosis is higher, up to 70% [ 24 ]. In a recent cohort of young women with normal ultrasound findings and pelvic gynaecological examination, endometriosis was diagnosed in 20% [ 25 ]. The incidence of surgically diagnosed endometriosis in our patient cohort is less, similar to the background population rate of 10–15% [ 26 ].…”