ROLE OF DIAGNOSTIC LAPAROSCOPY IN WOMEN WITH CHRONIC PELVIC PAIN
Journal Title: Indian Obstetrics & Gynaecology - Year 2017, Vol 7, Issue 2
Abstract
Aim: To evaluate causes of chronic pelvic pain (CPP) by diagnostic laparoscopy and to compare clinical findings with ultrasound and laparoscopic findings. Methods: Total 50 patients presenting with CPP to the gynaecological outpatient department were included in the study. After bimanual pelvic examination and routine investigations these patients were evaluated by ultrasonography (USG) followed by diagnostic laparoscopy in the postmenstrual period. Results: Clinical examination was able to pick up abnormalities in 23 cases (46%). However laparoscopy revealed pelvic pathology in 21 of the 27 cases found normal on clinical examination. Thus the sensitivity of clinical examination in diagnosing pelvic pathology was 52.27% vs laparoscopy. Similarly USG was able to pick up abnormalities in 27 cases (54%). All of these were confirmed on laparoscopy. However laparoscopy revealed pelvic pathology in 17 of the 23 cases found normal on USG. Thus the sensitivity of USG in diagnosing pelvic pathology was found to be 61.36% vs laparoscopy. Diagnostic laparoscopy was found to be significantly better in diagnosing the cause of chronic pelvic pain as compared to USG (p<0.001). Eighty eight percent cases revealed some or the other pelvic pathology on laparoscopy. Maximum cases (36%) were diagnosed as chronic pelvic inflammatory disease (PID) followed by endometriosis (26%), peri-tubal and peri-ovarian adhesions (16%), and ovarian cyst (10%). Three cases had fibroid uterus associated with chronic PID. All the 12% cases found normal on laparoscopy were also normal on pelvic examination and USG. Conclusions:Laparoscopy is the diagnostic modality of choice for evaluation of patients with chronic pelvic pain. It not only helps in diagnosing but also prognosticating the cases of pelvic adhesions and endometriosis where clinical examination and USG fail.
Authors and Affiliations
Dr. Mohini Paul, Dr. Sangeeta Ajmani, Dr. Kritika Vats
Keywords
Related Articles
- EP ID EP457789
- DOI -
- Views 86
- Downloads 0
Twin Pregnancy with Single Foetal Demise - Two Case Reports
Background: Twin pregnancy with single foetal demise is a rare condition with multiple maternal, foetal and unknown causes with significant maternal morbidity and high perinatal mortality and morbidity. The incidence of...
ROLE OF DIAGNOSTIC LAPAROSCOPY IN WOMEN WITH CHRONIC PELVIC PAIN
Aim: To evaluate causes of chronic pelvic pain (CPP) by diagnostic laparoscopy and to compare clinical findings with ultrasound and laparoscopic findings. Methods: Total 50 patients presenting with CPP to the gynaecolog...
OVARIAN RESERVE
Ovarian reserve determines the functional potential of ovary and reflects the quantity and quality of oocytes within it. As the number of in vitro fertilization (IVF) pregnancies is on the rise, it has become imperative f...
TRANSABDOMINAL CERCLAGE AND PERINATAL OUTCOMES —A FIVE YEARS RETROSPECTIVE STUDY
Background: Transabdominal placement of a cervical cerclage appears to be safe and effective procedure in reducing pregnancy loss in selected patients with cervical incompetence. It can be placed almost at the internal o...
Impact Of Pre-Pregnancy Body Mass Index, Anaemia And Gestational weight Gain On Neonatal Outcomes
Introduction:World Health Organization (WHO) study on maternal anthropometry and pregnancy outcomes across the world has indicated that mothers in the lowest quartile of pre-pregnancy weight were at the risk of increasin...