McCaughey Tristan, Younes Melissa M, Raoofi Mooska, Hicks Lauren, Amir Michal, Reddington Charlotte, Cheng Claudia, Healey Martin, Peate Michelle
Gynaecology 2 Unit (Endometriosis and Pelvic Pain), Royal Women's Hospital, Melbourne, Victoria, Australia.
Department of Obstetrics, Gynaecology and Newborn Health, Royal Women's Hospital, University of Melbourne, Melbourne, Victoria, Australia.
Aust N Z J Obstet Gynaecol. 2025 Jun;65(3):351-356. doi: 10.1111/ajo.13905. Epub 2024 Dec 9.
Laparoscopy has often been considered a core part of the workup for pelvic pain. However, many of these laparoscopies find no pathology.
To evaluate the experiences of patients following laparoscopy for pelvic pain when there is no diagnosis found.
This descriptive qualitative study reviewed patients who underwent a diagnostic laparoscopy for persistent pelvic pain with no pathology found. Participants completed a written questionnaire and an in-depth semi-structured interview. Interview data were thematically analysed.
Fifteen patients were interviewed with a median age of 30 years. Six themes were identified: desire for a diagnosis, hope as a coping strategy, inadequate communication, having 'next steps' of management offered, mental health impacts, and system issues. Participants wanted a diagnosis to help understand their condition, to enable connection with others, and believed that clinicians viewed pain with a diagnosis more seriously. Participants who were confident preoperatively that laparoscopy would lead to a diagnosis reported this contributing to poorer postoperative mental health. Participants discussed diagnoses not listed in the medical records, which provided hope for future management options. Participants reported worse mental health following the laparoscopy.
This study provides insight into the experiences of patients following a laparoscopy without an identifiable diagnosis. It highlights the importance of pre- and postoperative counselling, including discussing the potential for no findings at laparoscopy; the language used around other potential diagnoses; and the value in considering a patient's pre-existing mental health. The findings of this study are relevant for all clinicians counselling people with persistent pelvic pain where endometriosis is suspected.
腹腔镜检查常被视为盆腔疼痛检查的核心部分。然而，许多此类腹腔镜检查并未发现病理问题。
评估在未发现诊断结果的情况下，接受腹腔镜检查治疗盆腔疼痛的患者的经历。
这项描述性定性研究回顾了接受诊断性腹腔镜检查以治疗持续性盆腔疼痛但未发现病理问题的患者。参与者完成了一份书面问卷和一次深入的半结构化访谈。对访谈数据进行了主题分析。
对15名患者进行了访谈，中位年龄为30岁。确定了六个主题：渴望得到诊断、将希望作为应对策略、沟通不足、提供“下一步”治疗方案、对心理健康的影响以及系统问题。参与者希望得到诊断以帮助了解自己的病情，以便与他人建立联系，并认为临床医生会更认真地看待有诊断依据的疼痛。术前对腹腔镜检查能得出诊断结果充满信心的参与者表示，这导致了术后较差的心理健康状况。参与者讨论了病历中未列出的诊断，这为未来的治疗选择带来了希望。参与者报告称腹腔镜检查后心理健康状况较差。
本研究深入了解了腹腔镜检查后未明确诊断的患者的经历。它强调了术前和术后咨询的重要性，包括讨论腹腔镜检查可能无结果的可能性；围绕其他潜在诊断所使用的语言；以及考虑患者既往心理健康状况的价值。本研究结果与所有为疑似子宫内膜异位症的持续性盆腔疼痛患者提供咨询的临床医生相关。
