Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, 71-256 Szczecin, Poland.
Department of Medical Rehabilitation and Clinical Physiotherapy, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland.
Int J Environ Res Public Health. 2021 Jun 19;18(12):6606. doi: 10.3390/ijerph18126606.
Chronic pelvic pain affects approximately 15% of reproductive age women. It is mainly caused by adhesions (20-40%). Despite CPP being the main symptom of endometriosis, the disease is confirmed by laparoscopy only in 12-18% of cases. The aim of this study was to evaluate the results of laparoscopy in women with CCP and to assess the sensitivity and specificity of elements of an interview and clinical examination.
The study included 148 women with CPP. Each patient underwent laparoscopy. In laparoscopy, the presence of endometriosis and/or peritoneal adhesions was confirmed. Then, the sensitivity and specificity and the positive and negative predictive value of endometriosis symptoms or abnormalities in the gynecological examination were statistically calculated.
After previous surgery, adhesions were found in almost half (47%) of patients. In patients without a history of surgery, adhesions were diagnosed in 6.34% of patients. Endometriosis without coexisting adhesions was more often diagnosed in women without previous surgery (34.9%), compared to 10.58% in the group with a history of surgery ( < 0.05).
Intraperitoneal adhesions are most common in women after pelvic surgery and with chronic ailments. The best results for sensitivity, specificity, positive predictive value, and negative predictive value in the diagnosis of endometriosis are found in women with irregular menstruations during which the pain increases. Laparoscopy still remains the primary diagnostic and therapeutic method for these women.
慢性盆腔疼痛影响约 15%的育龄妇女。它主要由粘连引起（20-40%）。尽管慢性盆腔疼痛是子宫内膜异位症的主要症状，但只有 12-18%的病例通过腹腔镜确诊。本研究旨在评估腹腔镜在慢性盆腔疼痛妇女中的结果，并评估访谈和临床检查要素的敏感性和特异性。
该研究纳入了 148 名慢性盆腔疼痛妇女。每位患者均接受腹腔镜检查。腹腔镜下确认存在子宫内膜异位症和/或腹膜粘连。然后，统计计算子宫内膜异位症症状或妇科检查异常的敏感性、特异性、阳性预测值和阴性预测值。
既往手术后，近一半（47%）患者存在粘连。无手术史的患者中，粘连的诊断率为 6.34%。无并存粘连的子宫内膜异位症在无既往手术史的妇女中更为常见（34.9%），而有手术史的妇女中为 10.58%（<0.05）。
盆腔手术后和慢性疾病的妇女中最常见的是腹腔内粘连。在疼痛加重期间月经不规则的妇女中，子宫内膜异位症诊断的敏感性、特异性、阳性预测值和阴性预测值的最佳结果。腹腔镜仍然是这些妇女的主要诊断和治疗方法。
