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  • Title: Combined hysteroscopic and laparoscopic findings in patients with chronic pelvic pain.
    Author: Carter JE.
    Journal: J Am Assoc Gynecol Laparosc; 1994 Nov; 2(1):43-7. PubMed ID: 9050532.
    Abstract:
    STUDY OBJECTIVE: To document the abnormal findings at hysteroscopy and laparoscopy in patients with chromic pelvic pain. DESIGN: Prospective evaluation at surgery of women treated consecutively between January 1, 1991, and December 30, 1992. SETTING: A private practice. PATIENTS: One hundred forty-one women with pelvic pain (average age 35 yrs). INTERVENTIONS: Laparoscopy was performed in all patients, and hysteroscopy in all but one, who had had a hysterectomy. Endometrial and endocervical biopsies were performed. MEASUREMENTS AND MAIN RESULTS: In 42 (30%) of 140 patients with a primary diagnosis of chronic pelvic pain hysteroscopic evaluation with endometrial and endocervical biopsies revealed an abnormality. Findings at hysteroscopy included leiomyomas in 25 patients (18%), intrauterine polyps in 9 (6.4%), and cervical stenosis in 4 (2.9%). Three women (2.1%) had intrauterine scarring and one (0.7%) had a bicornuate uterus. Endometrial biopsies showed adenomatous hyperplasia with atypia, and cystic hyperplasia in one patient each. Endocervical biopsies revealed cervical dysplasia in four women (2. 89%). An abnormal finding was documented on laparoscopic examination in all 141 patients. These included endometriosis in 113 patients (80%), adhesions in 67 (48%), leiomyomas in 59 (42%), and enlarged globular uterus in 34 (24%). In addition, appendiceal abnormalities were present in three women (2.1%) and hernia in two (1.4%). CONCLUSIONS: Hysteroscopic abnormalities were found in 30% and laparoscopic abnormalities in 100% of patients who had a primary diagnosis of chronic pelvic pain.
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