RESUMEN
Chronic pelvic pain (CPP) is a common symptom and a difficult condition to manage especially during adolescence. The aim of this study was to evaluate the role of laparoscopy in the diagnosis and treatment of CPP during this period of life. From January 1993 to December 1997, 98 patients, selected from a group of 180 patients who were referred to our clinic underwent laparoscopy. In most cases (60%) no abnormalities were observed. Endometriosis was found in 25% of cases, followed by ovarian cysts 7%, parovarian cysts 3%, pelvic inflammatory disease 3% and adhesions 2%. Laparoscopic treatment was performed as indicated by laparoscopic findings. We conclude that laparoscopy is a valuable and effective procedure in the diagnosis and management of CPP in a selected group of patients.
Asunto(s)
Manejo de la Enfermedad , Laparoscopía , Dolor Pélvico/diagnóstico , Dolor Pélvico/cirugía , Adolescente , Adulto , Enfermedad Crónica , Endometriosis/cirugía , Estudios de Evaluación como Asunto , Femenino , Humanos , Laparoscopía/efectos adversos , Quistes Ováricos/cirugía , Quiste Paraovárico/cirugía , Valor Predictivo de las Pruebas , Adherencias Tisulares/cirugíaRESUMEN
Laparoscopy is the most frequent surgical approach in gynecologic patients with acute or chronic pelvic pain. The symptomatology is frequently related to a specific gynecological pathology such as endometriosis or associated adhesive disease. During an eight year period, January 1990 to December 1997, 26 patients (aged 16-20 years) with endometriosis were diagnosed endoscopically and managed pharmaceutically in our clinic. The disease was evaluated and staged according to the American Society of Reproductive Medicine. The disease was evaluated as first stage in 16 patients (61.6%), as second stage in eight patients (30.8%), as third stage in one patient (3.8%) and as fourth stage in one patient (3.8%). Patients underwent adhesiolysis and management according to their laparoscopic findings. Postoperative pharmaceutical treatment (Danazol, GnRH analogues, Oral Contraceptives) was given. Patients were followed for the evaluation of the treatment. The efficacy of the combination of endoscopic and pharmaceutical management of the disease is discussed.
Asunto(s)
Manejo de la Enfermedad , Endometriosis/diagnóstico , Endometriosis/tratamiento farmacológico , Adolescente , Adulto , Antineoplásicos Hormonales/uso terapéutico , Líquido Ascítico/patología , Anticonceptivos Orales/uso terapéutico , Danazol/uso terapéutico , Electrocoagulación , Endometriosis/cirugía , Antagonistas de Estrógenos/uso terapéutico , Estudios de Evaluación como Asunto , Femenino , Humanos , Laparoscopía , Leuprolida/uso terapéutico , Dolor/tratamiento farmacológico , Adherencias Tisulares/diagnóstico , Adherencias Tisulares/cirugía , Resultado del TratamientoRESUMEN
OBJECTIVE: To evaluate prophylactic oophorectomy in the prevention of ovarian cancer. METHOD: Between 1970 and 1990, 5262 hysterectomies were performed at Areteion Hospital, Athens. RESULTS: Ovarian cancer was subsequently diagnosed in 520 women (9.9%). The mean interval from hysterectomy to diagnosis of ovarian cancer was 7.2 years. If prophylactic bilateral oophorectomy had been practiced routinely in women undergoing hysterectomy at age 40 or above, 9.4% of cases would have been prevented. CONCLUSION: We recommend bilateral oophorectomy for all women with a positive family history of ovarian carcinoma and for all women undergoing hysterectomy after the age of 40. The decision for prophylactic oophorectomy as a complementary procedure to other indicated gynecologic surgeries should depend on the individual patient and her ability to comply with lifelong estrogen replacement therapy.