Drozgyik Istyván, Vizer Miklós, Szabó István
Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Pécs, H-7624 Pécs, Edesanyák útja 17, Hungary.
Eur J Obstet Gynecol Reprod Biol. 2007 Aug;133(2):223-6. doi: 10.1016/j.ejogrb.2006.05.035. Epub 2006 Jul 18.
Chronic pelvic pain is a complex disease and is far more common than generally recognized.
Between 1 January 1979 and 31 December 2002 authors had performed 11,681 laparoscopic interventions. Among them, 1061 operations (9.08%) were done because of chronic pelvic pain.
In 29.5% of these cases no anatomical abnormality was found. Analysis of data of laparoscopic operations performed from 1989 to 1990 and from 1998 to 1999 revealed that complaints dated back for a significantly longer period of time in patients presenting no obvious sign of pelvic anatomical anomaly when compared with those who had positive findings. In patients with positive pelvic findings laparotomy had previously been performed in a significantly higher number. When no apparent pelvic pathology was found medical history was also negative for ectopic pregnancy. Similarly, there were only three cases of previous adnexal operations. However, among patients with positive findings, medical history revealed 19 prior cases of ectopic pregnancy, 49 cases of previous adnexal operations, 82 appendectomy, and 26 cholecystectomy (p<0.01). Among patients with positive pelvic findings, diagnostic laparoscopy was immediately completed by adequate surgical treatment in the same session in more than two-third of cases. Most frequently this included adhesiolysis, ovarian cystectomy, uterosacral nerve ablation, electrocoagulation of areas of endometriosis, and ventrosuspension of the retroflected uterus.
Based on our retrospective data analysis we believe that laparoscopy is an essential method for the diagnosis and management of chronic pelvic pain.
慢性盆腔痛是一种复杂疾病，其发病率远比普遍认为的要高。
1979年1月1日至2002年12月31日期间，作者共进行了11681例腹腔镜手术。其中，因慢性盆腔痛进行的手术有1061例（9.08%）。
在这些病例中，29.5%未发现解剖学异常。对1989年至1990年以及1998年至1999年进行的腹腔镜手术数据进行分析发现，与有阳性发现的患者相比，盆腔无明显解剖异常迹象的患者症状持续时间明显更长。盆腔检查有阳性发现的患者此前接受剖腹手术的比例明显更高。当未发现明显盆腔病变时，病史中也无异位妊娠记录。同样，既往附件手术仅有3例。然而，在有阳性发现的患者中，病史显示既往有19例异位妊娠、49例附件手术、82例阑尾切除术和26例胆囊切除术（p<0.01）。在盆腔检查有阳性发现的患者中，超过三分之二的病例在同一手术中通过适当的手术治疗立即完成了诊断性腹腔镜检查。最常见的手术包括粘连松解术、卵巢囊肿切除术、子宫骶骨神经切除术、子宫内膜异位症区域电凝术以及后屈子宫悬吊术。
基于我们的回顾性数据分析，我们认为腹腔镜检查是诊断和治疗慢性盆腔痛的重要方法。
