ABSTRACT
AIM: In this study, the effectiveness of diagnostic laparoscopy, one of the methods used in the diagnosis and treatment of chronic pelvic pain, was investigated by the etiological examination of patients with chronic pelvic pain, who were treated and followed up on our clinic, allowing for gynecological, urological, and psychological factors. MATERIALS AND METHODS: In this study, the importance of diagnostic laparoscopy in chronic pelvic pain was assessed in 44 patients diagnosed with chronic pelvic pain between September 2005 and May 2006. Additionally, the records of 31 patients who did not have pelvic pain and on whom laparoscopy was performed due to tubal ligation at the same time were assessed. FINDINGS: The study group and the control group were compared in terms of laparoscopic findings. There were laparoscopic findings in 38 (86 %) of the 44 patients in the study group and pathological findings in 13 (41 %) of the 31 patients in the control group. Differences between the groups were statistically significant (p < 0.05). RESULT: Chronic pelvic pain is a syndrome in which biological and psychosocial factors play a role. Laparoscopy for chronic pelvic pain is an operation based on the "see and fight" principle.
Subject(s)
Chronic Pain/etiology , Genital Diseases, Female/complications , Pelvic Pain/etiology , Adolescent , Adult , Anxiety/complications , Case-Control Studies , Chi-Square Distribution , Chronic Pain/psychology , Chronic Pain/therapy , Coitus , Cystitis, Interstitial/complications , Cystitis, Interstitial/diagnosis , Cystoscopy , Depression/complications , Female , Genital Diseases, Female/psychology , Genital Diseases, Female/surgery , Humans , Laparoscopy , Middle Aged , Motor Activity , Pelvic Pain/psychology , Pelvic Pain/therapy , Posture , Sexual Dysfunctions, Psychological/complications , Somatoform Disorders/complications , Statistics, Nonparametric , Urinary Bladder/physiopathology , Young AdultABSTRACT
AIM: To investigate the short- and medium-term consequences of performing total salpingectomy during abdominal hysterectomy (without oophorectomy) on certain ovarian reserve parameters and blood flow velocity measurements through the ovarian stroma. METHODS: Twenty-four patients were recruited and randomized into two groups. Group 1 patients (n = 12) underwent total hysterectomy and complete excision of the fallopian tubes bilaterally. In group 2 (classical approach), fallopian tubes were removed partially leaving behind the neighboring paraovarian tissue. Pre- and postoperative (at 1 and 6 months) serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol values, ovarian volume estimation by transvaginal ultrasound, and ovarian stromal blood flow Doppler velocimetry were assessed during the early follicular phase. Mann-Whitney U-test, Student's t-test and Freidman's test were used for comparisons. RESULTS: Baseline data were similar across the groups (P > 0.05). Mean FSH, LH, estradiol values, and ovarian volume were unchanged after both of the techniques. However, mean pulsatility index, resistance index, and systole/diastole (S/D) ratio were significantly decreased in both groups compared to baseline values (group 1, P = 0.027, P = 0.018, and P = 0.013, respectively; group 2, P = 0.01, P = 0.002, and P = 0.0001, respectively). Postoperative decline in the mean pulsatility index was more pronounced (P = 0.02) in group 2 (partial removal). CONCLUSION: It appears that complete removal of fallopian tubes during hysterectomy has no advantageous effect on ovarian blood supply. It might be important to protect the ovarian blood supply as much as possible while performing hysterectomy in the reproductive period.
