ORIGINAL ARTICLES   

Minerva Ginecologica 2012 February;64(1):9-14

Copyright © 2012 EDIZIONI MINERVA MEDICA

language: Italian

Chronic pelvic pain in patients with endometriosis: results of laparoscopic treatment

Teodoro M. C., Genovese F., Rubbino G., Palumbo M. A., Zarbo G. ✉

Azienda Ospedaliera Universitaria, “Policlinico - V.E.”, Istituto di Patologia Ostetrica e Ginecologica, Presidio Ospedaliero “Santo Bambino”, Università degli Studi di Catania, Catania, Italia

AIM:The cronic pelvic pain (CPP) linked to endometriosis, relatively frequent condition in women of reprodutive age, often represents the main complaint for which the patient seeks medical advice. The purpose of this prospective study was to evaluate if and to which extent systematic ablation of endometriotic lesions causes an improvement and/or disappearance of pain in patients with ascertained endometriosis and in whom the main preoperative symptom is chronic pelvic pain.
METHODS: This study examined 109 patients, affected by chronic pelvic pain secondary to endometriosis, underwent laparoscopic treatment. All patients in the preoperative phase and only the 92 coming back for follow up, were asked both to fill out an anonymous questionnaire about their quality of life and to indicate on a numeric visual analogue scale (VAS) the intensity of the perceived pain.
RESULTS: Overall the median of the VAS score for pain decreased from 7.5 before surgery to 2.5 at one-year postoperative-follow up, which was consistent (Wilcoxon test) with a statistically significant regression (P<0.0001) of the intensity of perceived pain (disappearance or marked reduction) in the operated patients, independently from the stage of the disease and the type of pain; also data on quality of life during work and social activity indicated a relevant improvement respectively in 82% and in 83% of patients following the laparoscopic procedure.
CONCLUSION: For this reason and as suggested by the present international guidelines, when the medical therapy against pain fails and/or in the presence of an adnexal mass (chocolate cyst) or deep endometriotic lesion, it is generally correct to rely on surgical ablation of the lesions preferably by laparoscopy.