Laparoscopic surgery for pelvic pain
Surveys
have shown that about 1 in 6 women suffer from chronic pelvic pain at some time,
making it as common as asthma and backache. There can be several reasons for chronic
pain, but the three most common causes are endometriosis, irritable bowel syndrom
and intersitital cystitis (a condition affecting the bladder). Other gynaecological
causes include pelvic adhesions (particularly if dense and vascular), chronic pelvic
inflammatory disease (the late sequelae to pelvic infection), ovarian cysts, ovarian
remnant (ovarian tissue left after oophorectomy), trapped ovary (retained ovary buried
in adhesions after hysterectomy), and pelvic varicosities. Non-gynaecological causes
include nerve entrapment in scar tissue (e.g. ilio-inguinal nerve), inflammatory
bowel disease (e.g. Crohn's disease, ulcerative colitis), constipations, various
musculo-skeletal problems and hernias. Psychological factors can also play an important
role.
Laparoscopy may not only be useful in finding the cause of pain (see Diagnostic laparoscopy), but can be used for treatment. Laparoscopic ablation or excision of endometriosis, adhesiolysis, oophorectomy or salpingo-oophorectomy (removal of the ovaries with or without the fallopian tubes), uterine nerve ablation (LUNA), presacral neurectomy, appendicectomy and even pelvic clearance (hysterectomy and bilateral salpingo-oohorectomy) in severe cases are established treatment options when indicated. However, as is the case with any pain symptom, cure can never be guaranteed.