Tempest Nicola, Efstathiou Ekaterina, Petros Zena, Hapangama Dharani K
Liverpool Women's Hospital NHS Foundation Trust, member of Liverpool Health Partners affiliations, Liverpool L8 7SS, UK.
Department of Women's and Children's Health, Institute of Translational Medicine, University of Liverpool, member of Liverpool Health Partners affiliations, Liverpool L8 7SS, UK.
J Clin Med. 2020 Aug 10;9(8):2593. doi: 10.3390/jcm9082593.
Chronic pelvic pain (CPP) is one of the most common chronic pain problems experienced by women, with prevalence rates comparable to asthma and back pain. However, it is poorly understood and causative pathology is only seldom found. We aimed to establish prevalence of abnormal findings at diagnostic laparoscopy in young women with CPP after normal findings at clinical examination and pelvic ultrasound scan. Information was retrospectively collected on all laparoscopies undertaken on women aged 16-30 years with normal preoperative findings over a 24-month period. One-hundred-and-fifty women (mean age 25 years and BMI 24.5) were included with laparoscopic examination revealing normal anatomy in 110 (73.3%) and pathology in 40 (27.2%). Endometriosis was detected in 30 (20%); 25 (16.7%) stage 1, 2 (1.3%) stage 2, 2 (1.3%) stage 3 and 1 (0.7%) stage 4. Most laparoscopies carried out on young women with CPP and normal clinical examination and pelvic ultrasound scan showed no significant clinical stigmata of pelvic disease. Women should be fully informed of the multifactorial nature of CPP and there should be a comprehensive management pathway for these women, as proceeding with invasive laparoscopy does not provide additional benefit when investigating CPP in the context of risk, cost and effect on long-term wellbeing.
慢性盆腔疼痛（CPP）是女性最常见的慢性疼痛问题之一，其患病率与哮喘和背痛相当。然而，人们对其了解甚少，且很少能找到致病病理。我们旨在确定在临床检查和盆腔超声扫描结果正常的年轻CPP女性患者中，诊断性腹腔镜检查异常发现的患病率。回顾性收集了在24个月内对16至30岁、术前检查结果正常的女性进行的所有腹腔镜检查信息。纳入了150名女性（平均年龄25岁，体重指数24.5），腹腔镜检查显示110名（73.3%）解剖结构正常，40名（27.2%）有病理改变。30名（20%）检测出子宫内膜异位症；25名（16.7%）为1期，2名（1.3%）为2期，2名（1.3%）为3期，1名（0.7%）为4期。对大多数临床检查和盆腔超声扫描正常的年轻CPP女性进行的腹腔镜检查未显示出明显的盆腔疾病临床体征。应让女性充分了解CPP的多因素性质，并且应为这些女性制定全面的管理途径，因为在考虑风险、成本和对长期健康的影响时，进行侵入性腹腔镜检查在调查CPP时并不会带来额外益处。
