Laparoscopic findings, histopathologic evaluation, and clinical outcomes in women with chronic pelvic pain after hysterectomy and bilateral salpingo-oophorectomy.

STUDY OBJECTIVE To laparoscopically evaluate the pelvis of patients with chronic pelvic pain after hysterectomy and bilateral salpingo-oophorectomy, to determine any associated factors to the pain. DESIGN Retrospective cohort of patients with chronic pelvic pain after hysterectomy and bilateral salpingo-oophorectomy (Canadian Task Force Classification II-2). SETTING University-affiliated teaching hospital. PATIENTS From January 1990 through May 2002, 124 women with chronic pelvic pain after hysterectomy and bilateral salpingo-oophorectomy underwent laparoscopic and histopathologic evaluation of the pelvis. INTERVENTION Diagnostic laparoscopy was performed to inspect the pelvis for any signs of pathology. If any abnormalities were visualized, they were treated with CO2 laser resection and sent for histopathologic evaluation. MAIN OUTCOME MEASURES Laparoscopic and histopathologic findings of the pelvis, as well as subjective pain improvement after laparoscopy. CONCLUSION The most common histopathologic findings at laparoscopy in women with chronic pelvic pain after hysterectomy and bilateral salpingo-oophorectomy included adhesions, adnexal remnants, and endometriosis. Laparoscopic treatment of any pelvic pathologic condition improved pain symptoms in these women.