Laparoscopic findings, histopathologic evaluation, and clinical outcomes in women with chronic pelvic pain after hysterectomy and bilateral salpingo-oophorectomy

STUDY OBJECTIVE: To laparoscopically evaluate the pelvis of patients with chronic pelvic pain after hysterectomy and bilateral salpingo-oophorectomy, to determine any associated factors to the pain. DESIGN: Retrospective cohort of patients with chronic pelvic pain after hysterectomy and bilateral salpingo-oophorectomy (Canadian Task Force Classification II-2). SETTING: University-affiliated teaching hospital. PATIENTS: From January 1990 through May 2002, 124 women with chronic pelvic pain after hysterectomy and bilateral salpingo-oophorectomy underwent laparoscopic and histopathologic evaluation of the pelvis. INTERVENTION: Diagnostic laparoscopy was performed to inspect the pelvis for any signs of pathology. If any abnormalities were visualized, they were treated with CO2 laser resection and sent for histopathologic evaluation. MAIN OUTCOME MEASURES: Laparoscopic and histopathologic findings of the pelvis, as well as subjective pain improvement after laparoscopy. CONCLUSION: The most common histopathologic findings at laparoscopy in women with chronic pelvic pain after hysterectomy and bilateral salpingo-oophorectomy included adhesions, adnexal remnants, and endometriosis. Laparoscopic treatment of any pelvic pathologic condition improved pain symptoms in these women. (C) 2006 AAGL. All rights reserved.