The Role of Diagnostic Laparoscopy in Chronic Pelvic Pain

Abstract

One of the commonest symptomatology in gynecological outpatient clinics is chronic pelvic pain, it accounts for 10% of gynecologist’s general clinics patients. The study aimed to To evaluate the role of laparoscopy in evaluation of CPP, and its correlation with clinical examination and vaginal ultrasound examination. The present prospective study was done in the Department of Obstetrics and Gynecology Salah Al-Deen general hospital in Tikrit city from 1stApril- 31st August 2020. The study sample consists of 30 patients with chronic pelvic pain, according to the ACOG criteria, with a convenient sampling method. The data collection done through: a designed closed and open-ended questionnaire, physical examination, transvaginal ultrasound & laparoscopic examination for the 30 patients for evaluation of chronic pelvic pain. By laparoscopic examination (90%) of patients had positive findings, pelvic examination identified (89%) of them correctly. Those with negative findings in laparoscopy was (10%) of patient, (33.3%) of them were diagnosed as negative by pelvic examination, there were miss diagnosis in (67%) of the negative patient and (11.1%) of positive diagnosed patient, this was a statically significant relation. Sensitivity of TVS was 85%, versus 89% for the pelvic examination. Specificity for TVS, and pelvic examination was (100%), (33%) respectively. Accuracy of the test for TVS, and pelvic examination was (87%), (83%) respectively. Exploratory laparoscopy provides a definitive diagnosis in 90% of women complaining of unexplained CPP. The surgical treatment of these lesions improves painful symptomatology in 70% of women.

Laparoscopic Assessment of the Tubo Ovarian Relationship in Unexplained Infertility

“…Adhesions can, however, be seen in women with generalized discomfort. Although adhesiolysis cannot always be blamed for the discomfort, it does frequently result in a reduction in symptoms [8]. The study's goal is to use laparoscopy to determine the incidence of aberrant tubo-ovarian relationships in women with unexplained infertility.…”