Prospective randomized trial of right-sided paracolic adhesiolysis for chronic pelvic pain. |
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Authors: | Martin D Keltz Puja Sharma Gera David L Olive |
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Institution: | Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, St. Luke's-Roosevelt Hospital Center, Columbia College of Physicians and Surgeons, New York, New York 10019, USA. |
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Abstract: | BACKGROUND: Prior study has shown that right paracolic adhesions are found in 90% of patients with chronic pelvic pain and less frequently in pain-free patients. We set out to determine whether paracolic adhesiolysis will reduce site-specific pain. METHODS: This was a prospective, randomized trial of right paracolic adhesiolysis at the time of diagnostic and operative laparoscopy for chronic pelvic pain. Twenty-five patients with a diagnosis of chronic pelvic pain were randomized to either undergo or withhold lysis of right paracolic adhesions at the time of operative laparoscopy. RESULTS: Right paracolic adhesions were found in 100% of our patients. For all subjects, there was a significant reduction of right and left lower quadrant pain (P<0.001) following the operative laparoscopy. Those who underwent right paracolic adhesiolysis had significantly greater right pelvic pain reduction than those who did not (P=0.014). There was no difference in the reduction of left or mid pelvic pain between the treatment and control groups. CONCLUSIONS: Right paracolic adhesiolysis reduces short-term site-specific tenderness in patients with chronic pelvic pain. Patients who would benefit from diagnostic or operative laparoscopy are likely to benefit further from paracolic adhesiolysis. |
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Keywords: | Chronic pelvic pain Paracolic adhesions Laparoscopy Adhesiolysis |
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