Laparoscopy: A See- and -treat Modality for Lower Abdominal Pain in Females

Abstract

Background: In females, lower abdominal pain (LAP) is a common presenting complaint that has a diverse etiology. It can involve reproductive, gastrointestinal, genitourinary, and musculoskeletal systems; therefore, accurate diagnosis is a clinical challenge. Laparoscopy has become the gold standard for the diagnosis and management of LAP. Aims and objectives: To diagnose the cause of LAP with laparoscopy and to correlate it with clinical examination and ultrasound. Materials and methods: A prospective study was conducted from December 2012 to January 2015 in JNMCH, Aligarh. Laparoscopy was performed on 84 patients with complaints of LAP (acute, subacute, or chronic). Data were statistically analyzed on the basis of the epidemiology, clinical features, ultrasound findings, and laparoscopic findings. Correlation of clinical, ultrasound, and laparoscopic finding was done. Results: With laparoscopy, diagnosis was established in 94.1% ( n = 79) of patients. The most common cause of LAP was pelvic inflammatory disease (PID) present in 20.2% ( n = 17) of patients followed by endometriosis in 17.9% ( n = 15), ectopic pregnancy in 15.5% ( n = 13), ovarian cyst in 15.5% ( n = 13), genital TB in 7.1% ( n = 6), etc. Therapeutic laparoscopy was performed in 82.1% ( n = 69) of women, which included adhesiolysis, cystectomy, cystotomy, salpingectomy, salpingostomy fulguration of endometriotic lesions, ovarian drilling, myomectomy, and salpingo-ophorectomy. Conclusion: Laparoscopy can be used as the first-line interventional investigation for LAP. Besides diagnosis, it also has a therapeutic role. Therefore, it can be considered as a “see and treat” modality.