@misc{cogprints5141,
          volume = {1},
          number = {3},
           month = {September},
          author = {Shripad Hebbar and Chander Chawla},
           title = {Role of laparoscopy in evaluation of chronic pelvic pain

},
       publisher = {Medknow Publications},
         journal = {Journal of Minimal Access Surgery},
            year = {2005},
        keywords = {chronic pelvic pain; endometriosis; laparoscopy; pelvic adhesions},
             url = {http://cogprints.org/5141/},
        abstract = {Introduction: Chronic pelvic pain (CPP) is a common medical problem affecting women. Too often the physical signs are not specific. This study aims at determining the accuracy of diagnostic laparoscopy over clinical pelvic examination. Settings and Design: A retrospective study of patients who underwent diagnostic laparoscopy for CPP. Materials and Methods: The medical records of 86 women who underwent laparoscopic evaluation for CPP of at least 6-month duration were reviewed for presentation of symptoms, pelvic examination findings at the admission, operative findings and follow up when available. Statistical analysis used: McNemar Chi-square test for frequencies in a 2 x 2 table. Results: The most common presentation was acyclic lower abdominal pain (79.1\%), followed by congestive dysmenorrhoea (26.7\%). 61.6\% of women did not reveal any significant signs on pelvic examination. Pelvic tenderness was elicited in 27.9\%. Diagnostic laparoscopy revealed significant pelvic pathology in 58\% of those who essentially had normal pervaginal findings. The most common pelvic pathology by laparoscopy was pelvic adhesions (20.9\%), followed by pelvic congestion (18.6\%). Laparoscopic adhesiolyis achieved pain relief only in one-third of the women. Conclusion: The study revealed very low incidence of endometriosis (4.7\%). Overall clinical examination could detect abnormality in only 38\% of women, where as laparoscopy could detect significant pathology in 66\% of women with CPP. This shows superiority of diagnostic laparoscopy over clinical examination in detection of aetiology in women with CPP (P {\ensuremath{<}} 0.001). Adhesiolysis helps only small proportion of women in achieving pain control.

}
}

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