Effect of tubal ligation on pelvic endometriosis externa in multiparous women with chronic pelvic pain.

ABSTRACT

OBJECTIVE: To determine whether tubal ligation is associated with decreased prevalence and less severity of pelvic endometriosis in multiparous patients with chronic pelvic pain. MATERIAL AND METHOD: From January 1995 to April 2002, 322 chronic pelvic pain patients underwent laparoscopy. Of these, 125 patients were multiparous (parity > or = 2). Their obstetric history, present contraceptive methods and laparoscopic findings were recorded perioperatively. The medical record of each patient was reviewed and analyzed. RESULTS: Among multiparous women with chronic pelvic pain, the prevalence of endometriosis in patients with and without tubal ligation was 45.1% (23 of 51 patients) and 59.5% (44 of 74 patients), respectively. Moderate-severe endometriosis was found in 8.7% (2 of 23 patients) and 36.4% (16 of 44 patients) among patients with and without sterilization. Tubal ligation was statistically significantly associated with severity of disease [P = 0.036, Crude OR (95% CI) = 0.17 (0.02-0.85), Adjusted OR (95% CI) = 0.21 (0.04-1.08)]. There was no statistically significant relationship between tubal ligation and prevalence of endometriosis. The small sample size of the study might account for this statistical result. CONCLUSION: Nearly half of multiparous women with chronic pelvic pain and tubal ligation had endometriosis. Tubal ligation was related to less severity of disease, with statistically significant difference.