Diagnostic laparoscopy, infertility, and endometriosis - 5 Years experience

Abstract

The objectives of this study were to determine the importance of diagnostic laparoscopy for the accurate diagnosis of endometriosis and to correlate the findings with infertility. Participants in this study included 336 women who were 18-45 years old, had no past medical history of abdominal operations, and complained of chronic symptoms of pelvic pain. In all these cases there were no pathological pelvic ultrasound findings. Also, nongynaecological diseases where excluded. Diagnostic laparoscopy was performed in all patients. In 191 women (56.8%) no pathology was found during the diagnostic laparoscopy, and 89 women (26.4%) actually reported improvement or even complete cure from their symptoms after the operation. In the majority of pathological cases the laparoscopy revealed various stages of endometriosis (n=101; 30%). Other gynecological causes which were diagnosed during the laparoscopy where pelvic adhesions due to inflammatory disease (n=37; 11%), ovarian cysts (n=5; 1.5%), and uterine fibroids (n=2; 0.5%). Diagnostic laparoscopy is the most accurate method for excluding the pathology related with chronic pelvic pain. Endometriosis seems to be responsible for the majority of pathological cases. Almost 60% of women have no pathology when examined with laparoscopy. A high percentage of symptoms can be phycogenic. © 2007 Springer-Verlag.