Tags

Type your tag names separated by a space and hit enter

Laparoscopic findings, management, histopathology, and outcome of 25 women with cyclic leg pain.
J Am Assoc Gynecol Laparosc 2002; 9(2):145-51JA

Abstract

STUDY OBJECTIVE

To determine pelvic findings, histopathology, and clinical outcome in women with chronic pelvic pain and cyclic sciatica-like pain after laparoscopic surgery.

DESIGN

Retrospective cohort study (Canadian Task Force classification II-2).

SETTING

University-affiliated teaching hospital.

PATIENTS

Of 2115 women with chronic pelvic pain, 25 also complained of cyclic pain radiating to the leg (right 15, left 9, both 1), pain over buttocks, and paresthesia of the thighs and/or knees, exacerbated during menses.

INTERVENTION

Laparoscopy.

MEASUREMENTS AND MAIN RESULTS

Laparoscopic findings were endometriosis nodules (5 patients), peritoneal pockets and/or peritoneal endometriosis (19), and inflammatory peritoneum (1). Associated pelvic endometriosis was identified and confirmed in 17 women (68%). No additional lesions other than peritoneal pockets were found in eight (32%). All nodules, peritoneal pockets, and abnormal peritoneum were excised with a combination of hydrodissection and carbon dioxide laser. Peritoneum over resultant deep defects was sutured with one to three 2-0 nonabsorbable sutures in accordance with the surgeon's practice and experience. Endometriosis was confirmed in all five nodules, and histology of excised pockets showed endometriosis in nine (60.0%), endosalpingiosis in two (13.3%), chronic inflammation in one (6.7%), and normal tissue in three (20.0%). After laparoscopic excision sciatic symptoms were eliminated in 19, markedly improved in 4, remained the same in 2, and recurred in 3 patients after 2 years.

CONCLUSION

Cyclic leg signs and symptoms were associated with pelvic peritoneal pockets, endometriosis nodules, or surface endometriosis of the posterolateral pelvic peritoneum. We hypothesize that the pain associated with these lesions is more likely referred pain originating from pelvic peritoneum than direct irritation of the lumbosacral plexus of the sciatic nerve.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, St. Joseph's Health Care, 268 Grosvenor Street, London, Ontario N6A 4V2, Canada.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11960038

Citation

Vilos, George A., et al. "Laparoscopic Findings, Management, Histopathology, and Outcome of 25 Women With Cyclic Leg Pain." The Journal of the American Association of Gynecologic Laparoscopists, vol. 9, no. 2, 2002, pp. 145-51.
Vilos GA, Vilos AW, Haebe JJ. Laparoscopic findings, management, histopathology, and outcome of 25 women with cyclic leg pain. J Am Assoc Gynecol Laparosc. 2002;9(2):145-51.
Vilos, G. A., Vilos, A. W., & Haebe, J. J. (2002). Laparoscopic findings, management, histopathology, and outcome of 25 women with cyclic leg pain. The Journal of the American Association of Gynecologic Laparoscopists, 9(2), pp. 145-51.
Vilos GA, Vilos AW, Haebe JJ. Laparoscopic Findings, Management, Histopathology, and Outcome of 25 Women With Cyclic Leg Pain. J Am Assoc Gynecol Laparosc. 2002;9(2):145-51. PubMed PMID: 11960038.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic findings, management, histopathology, and outcome of 25 women with cyclic leg pain. AU - Vilos,George A, AU - Vilos,Andrew W, AU - Haebe,Jeffrey J, PY - 2002/4/18/pubmed PY - 2002/6/1/medline PY - 2002/4/18/entrez SP - 145 EP - 51 JF - The Journal of the American Association of Gynecologic Laparoscopists JO - J Am Assoc Gynecol Laparosc VL - 9 IS - 2 N2 - STUDY OBJECTIVE: To determine pelvic findings, histopathology, and clinical outcome in women with chronic pelvic pain and cyclic sciatica-like pain after laparoscopic surgery. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2). SETTING: University-affiliated teaching hospital. PATIENTS: Of 2115 women with chronic pelvic pain, 25 also complained of cyclic pain radiating to the leg (right 15, left 9, both 1), pain over buttocks, and paresthesia of the thighs and/or knees, exacerbated during menses. INTERVENTION: Laparoscopy. MEASUREMENTS AND MAIN RESULTS: Laparoscopic findings were endometriosis nodules (5 patients), peritoneal pockets and/or peritoneal endometriosis (19), and inflammatory peritoneum (1). Associated pelvic endometriosis was identified and confirmed in 17 women (68%). No additional lesions other than peritoneal pockets were found in eight (32%). All nodules, peritoneal pockets, and abnormal peritoneum were excised with a combination of hydrodissection and carbon dioxide laser. Peritoneum over resultant deep defects was sutured with one to three 2-0 nonabsorbable sutures in accordance with the surgeon's practice and experience. Endometriosis was confirmed in all five nodules, and histology of excised pockets showed endometriosis in nine (60.0%), endosalpingiosis in two (13.3%), chronic inflammation in one (6.7%), and normal tissue in three (20.0%). After laparoscopic excision sciatic symptoms were eliminated in 19, markedly improved in 4, remained the same in 2, and recurred in 3 patients after 2 years. CONCLUSION: Cyclic leg signs and symptoms were associated with pelvic peritoneal pockets, endometriosis nodules, or surface endometriosis of the posterolateral pelvic peritoneum. We hypothesize that the pain associated with these lesions is more likely referred pain originating from pelvic peritoneum than direct irritation of the lumbosacral plexus of the sciatic nerve. SN - 1074-3804 UR - https://www.unboundmedicine.com/medline/citation/11960038/Laparoscopic_findings_management_histopathology_and_outcome_of_25_women_with_cyclic_leg_pain_ L2 - https://medlineplus.gov/endometriosis.html DB - PRIME DP - Unbound Medicine ER -