Chronic pelvic pain. Laparoscopic and cystoscopic findings

OBJECTIVE: To study the laparoscopic and cystoscopic findings in women with chronic pelvic pain referred to the Gynecology Clinic at Sultan Qaboos University Hospital.

METHODS: Women referred to Sultan Qaboos University Hospital, Sultanate of Oman from October 1998-September 2000 with pelvic pain of more than 6 months duration were clinically evaluated. Laparoscopic examination was always combined with cystoscopy. Bladder biopsy was performed only if there were doubts regarding the nature of pathology that was found.

RESULTS: The mean age of the patients was 31 years and mean parity was 3.0. The minimum duration of symptoms was 6 months, but one 3rd of the patients had pain for more than 2 years. Bladder symptoms were present in 50% and bowel symptoms in 25% of patients. Laparoscopic examination revealed pathological findings in 80% of the cases. Adhesions of the omentum to the uterus or to the laparotomy or laparoscopy scar were the most common pathology (50%). Cystoscopy revealed one case of trigonitis and one case of cystitis.

CONCLUSION: Pelvic adhesions were the most common cause of pelvic pain in our study group. Cystoscopy was normal in most of the patients.