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Histopathologic findings on uterosacral ligaments in women with chronic pelvic pain and visually normal pelvis at laparoscopy.
J Minim Invasive Gynecol 2006 May-Jun; 13(3):201-4JM

Abstract

STUDY OBJECTIVE

To determine the prevalence and type of microscopic findings on laparoscopically resected uterosacral ligaments in women with chronic pelvic pain and no visible pelvic disease. The effect of this procedure on the patients' level of pain also was assessed as a secondary objective.

DESIGN

Prospective follow-up (Canadian Task Force classification II-2).

SETTING

University-affiliated hospital.

PATIENTS

Twenty-seven premenopausal women undergoing diagnostic laparoscopy for chronic pelvic pain had a normal pelvis on visual inspection. All patients underwent resection and histologic evaluation of the uterosacral ligaments. Pain relief was evaluated by use of a questionnaire administered before and at 3, 6, and 12 months after surgery.

MEASUREMENTS AND MAIN RESULTS

Microscopic examination identified endometriosis in 2 (7.4%), endosalpingiosis in 3 (11.1%), and inflammation in 14 (51.9%) patients. Laparoscopic uterosacral ligament resection was associated with a reduction in dysmenorrhea (p < or = .001), with 14 (52%) patients reporting improved or resolved symptoms. There was a statistically significant decrease in dyspareunia (p < or = .01) and in the severity of noncyclical pain (p < or = .002). Thirty-five percent of patients no longer required medication for pain control (p < or = .005). The number of days needed off work also decreased.

CONCLUSION

Despite normal laparoscopic appearance, microscopic endometriosis, endosalpingiosis, and inflammatory changes were found in uterosacral ligaments in 17 (63%) women with chronic pelvic pain. Laparoscopic resection of uterosacral ligaments improved dysmenorrhea, dyspareunia, and noncyclical pain and decreased the number of days lost from work, as well as the proportion of patients who required medication for pain control.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, St. Joseph's Health Care, The University of Western Ontario, London, Ontario, Canada. pnascu@uwo.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16698525

Citation

Nascu, Patricia C., et al. "Histopathologic Findings On Uterosacral Ligaments in Women With Chronic Pelvic Pain and Visually Normal Pelvis at Laparoscopy." Journal of Minimally Invasive Gynecology, vol. 13, no. 3, 2006, pp. 201-4.
Nascu PC, Vilos GA, Ettler HC, et al. Histopathologic findings on uterosacral ligaments in women with chronic pelvic pain and visually normal pelvis at laparoscopy. J Minim Invasive Gynecol. 2006;13(3):201-4.
Nascu, P. C., Vilos, G. A., Ettler, H. C., Abu-Rafea, B., Hollet-Caines, J., & Ahmad, R. (2006). Histopathologic findings on uterosacral ligaments in women with chronic pelvic pain and visually normal pelvis at laparoscopy. Journal of Minimally Invasive Gynecology, 13(3), pp. 201-4.
Nascu PC, et al. Histopathologic Findings On Uterosacral Ligaments in Women With Chronic Pelvic Pain and Visually Normal Pelvis at Laparoscopy. J Minim Invasive Gynecol. 2006;13(3):201-4. PubMed PMID: 16698525.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Histopathologic findings on uterosacral ligaments in women with chronic pelvic pain and visually normal pelvis at laparoscopy. AU - Nascu,Patricia C, AU - Vilos,George A, AU - Ettler,Hellen C, AU - Abu-Rafea,Basim, AU - Hollet-Caines,Jackie, AU - Ahmad,Riad, PY - 2005/12/16/received PY - 2006/02/08/revised PY - 2006/02/13/accepted PY - 2006/5/16/pubmed PY - 2006/10/25/medline PY - 2006/5/16/entrez SP - 201 EP - 4 JF - Journal of minimally invasive gynecology JO - J Minim Invasive Gynecol VL - 13 IS - 3 N2 - STUDY OBJECTIVE: To determine the prevalence and type of microscopic findings on laparoscopically resected uterosacral ligaments in women with chronic pelvic pain and no visible pelvic disease. The effect of this procedure on the patients' level of pain also was assessed as a secondary objective. DESIGN: Prospective follow-up (Canadian Task Force classification II-2). SETTING: University-affiliated hospital. PATIENTS: Twenty-seven premenopausal women undergoing diagnostic laparoscopy for chronic pelvic pain had a normal pelvis on visual inspection. All patients underwent resection and histologic evaluation of the uterosacral ligaments. Pain relief was evaluated by use of a questionnaire administered before and at 3, 6, and 12 months after surgery. MEASUREMENTS AND MAIN RESULTS: Microscopic examination identified endometriosis in 2 (7.4%), endosalpingiosis in 3 (11.1%), and inflammation in 14 (51.9%) patients. Laparoscopic uterosacral ligament resection was associated with a reduction in dysmenorrhea (p < or = .001), with 14 (52%) patients reporting improved or resolved symptoms. There was a statistically significant decrease in dyspareunia (p < or = .01) and in the severity of noncyclical pain (p < or = .002). Thirty-five percent of patients no longer required medication for pain control (p < or = .005). The number of days needed off work also decreased. CONCLUSION: Despite normal laparoscopic appearance, microscopic endometriosis, endosalpingiosis, and inflammatory changes were found in uterosacral ligaments in 17 (63%) women with chronic pelvic pain. Laparoscopic resection of uterosacral ligaments improved dysmenorrhea, dyspareunia, and noncyclical pain and decreased the number of days lost from work, as well as the proportion of patients who required medication for pain control. SN - 1553-4650 UR - https://www.unboundmedicine.com/medline/citation/16698525/Histopathologic_findings_on_uterosacral_ligaments_in_women_with_chronic_pelvic_pain_and_visually_normal_pelvis_at_laparoscopy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1553-4650(06)00072-0 DB - PRIME DP - Unbound Medicine ER -