World Journal of Laparoscopic Surgery

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VOLUME 17 , ISSUE 2 ( May-August, 2024 ) > List of Articles

Original Article

Diagnostic Laparoscopy for Chronic Pelvic Pain after Hysterectomy: A Nonrandomized Control Study from North India

Majid Mushtaque, Sieqa Shah, Samina Ali Khanday, Ajaz A Rather, Ibrahim R Guroo

Keywords : Chronic pelvic pain, Diagnostic laparoscopy, Hysterectomy

Citation Information : Mushtaque M, Shah S, Khanday SA, Rather AA, Guroo IR. Diagnostic Laparoscopy for Chronic Pelvic Pain after Hysterectomy: A Nonrandomized Control Study from North India. World J Lap Surg 2024; 17 (2):89-93.

DOI: 10.5005/jp-journals-10033-1609

License: CC BY-NC 4.0

Published Online: 18-04-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Background: Chronic pelvic pain (CPP) following a surgical procedure has been reported to affect a significant number of patients and is associated with a decreased quality of life. Objective: To evaluate CCP laparoscopically in patients who had previously undergone hysterectomy for benign lesions. Materials and methods: A multicentric study conducted over a period of 8 years. The study group included 88 females with posthysterectomy CPP of more than 8 months in whom a definitive diagnosis was either not reached or was in doubt despite thorough clinical and radiological investigations. Fifty-four patients agreed to the procedure while 34 patients were treated conservatively. Baseline characteristics, subjective pain relief, and overall patient satisfaction were compared between the two groups. Results: The mean age of the patients, body mass index (BMI), duration of symptoms, preoperative visual analog scale (VAS) for pain, and primary approach for hysterectomy were found to be statistically insignificant between the operative and conservative groups (p > 0.05). The most common indications for previous hysterectomy in both groups were dysfunctional uterine bleeding and leiomyoma. The most frequent findings at diagnostic laparoscopy were adhesions (53.70%), cystic lesions of preserved functional ovary (22.22%), and hydro/pyosalpinx (9.25%). Ten (18.51%) patients did not reveal any obvious positive finding. Adhesiolysis and ovarian cystectomy were the most frequently done procedures. Laparoscopic diagnosis was confirmed by histopathology in most of the patients. Improvement in VAS score was more significant in the operated group than in the conservative group. Conclusion: Diagnostic laparoscopy is an effective and accurate tool to evaluate CPP after gynecological surgery apart from being an excellent approach for therapeutic interventions.

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