[Place of exploratory laparoscopy in the diagnosis and treatment of chronic pelvic pain].

Abstract

Objectives: Chronic pelvic pain (CPP) accounts for 15 to 40 % of exploratory laparoscopies. An exploratory laparoscopy was performed to exclude the presence of peritoneal endometriosis in patients experiencing significant impairment of their quality of life.

Methods: This retrospective observational study was carried out in a tertiary referral center for endometriosis. Forty-six patients with CPP, including a non contributive clinical examination and additional investigations, underwent exploratory laparoscopy. They were divided into three subgroups : patients with a history of endometriosis (group 1), those with another non-gynecological concomitant etiology of CPP (group 2) and those without any primary etiological diagnosis (group 3). We report the observed endometriosis lesions, surgical techniques applied and histopathological results.

Results: Exploratory laparoscopy revealed endometriosis lesions in 93.5 % of cases. Endometriosis lesions were found in 85 % of cases in group 1 (n = 20), 100 % in group 2 (n = 6) and 80 % in group 3 (n = 20).

Conclusion: Exploratory laparoscopy maintains a fundamental role in the diagnosis of patients with CPP, enabling simultaneous visualization and surgical treatment of endometriosis lesions.