Subjective evaluation of the therapeutic value of laparoscopic adhesiolysis: a retrospective analysis.

BACKGROUND

Adhesions are believed to be one of the principal causes of chronic pelvic pain. Although there may be some discrepancy between the degree of adhesions and the severity of the symptoms, surgical adhesiolysis is still considered to be useful for the relief of pain.

METHODS

A total of 187 patients who underwent laparoscopic adhesiolysis at the Medical University of Ulm, Germany, within a 2-year period were asked to rank their discomfort on a visual pain scale before surgery and up to 1 1/2 years postoperatively.

RESULTS

In this retrospective study, we found that nearly one-third of patients suffered from functional irritations that were either ameliorated or completely relieved by laparoscopic adhesiolysis. When other causes of chronic pain (such as endometriosis) are excluded, the results show that most patients benefited from laparoscopic adhesiolysis.

CONCLUSIONS

It appears that laparoscopic adhesiolysis is an effective therapeutic measure to relieve chronic pelvic pain. Therefore, adhesiolysis should be performed in all patients with chronic or intermittent pain, and a complete lysis of adhesions should be planned. However, since pelvic pain may have organic or functional causes other than adhesions, complete adhesiolysis in patients with persistent pelvic pain may be of only limited importance.