STUDY OBJECTIVE: To evaluate adolescent girls with chronic pelvic pain not responding to conventional medical therapy, using advances in operative laparoscopy to determine endometriosis prevalence, clinical stage, and type of lesion. DESIGN: A descriptive retrospective study of subjects who (1) were referred for the evaluation of chronic pelvic pain, (2) did not respond to a nonsteroidal anti-inflammatory drug and an oral contraceptive pill, and (3) underwent a laparoscopy to determine the etiology of the pelvic pain. SETTING: Patients referred to a surgical gynecologist in a pediatric/adolescent gynecology and reproductive endocrine academic practice. PARTICIPANTS: All patients younger than 22 years of age with chronic pelvic pain. INTERVENTION: Operative laparoscopy to determine the etiology of the chronic pelvic pain. MAIN OUTCOME MEASURES: Operative laparoscopy results including stage and description of endometriosis. RESULTS: More than two thirds of the study population (69.6%) was found to have endometriosis. All subjects had either stage I or II as determined by the American Fertility Society's classification system. The nature of the pain in the 32 subjects with endometriosis was both acyclic and cyclic in 20 (62.5%), acyclic only in 9 (28.1%), and cyclic only in 3 (9.4%). Other presenting symptoms included gastrointestinal in 11 (34.3%), urinary in 4 (12.5%), and irregular menses in 3 (9.4%). CONCLUSIONS: Adolescents with chronic pelvic pain not responding to medical therapy have a high rate of endometriosis and should be referred to a gynecologist who is experienced with the subtle laparoscopic findings of atypical endometriosis to diagnose the etiology of the pelvic pain and initiate appropriate therapy.
STUDY OBJECTIVE: To evaluate adolescent girls with chronic pelvic pain not responding to conventional medical therapy, using advances in operative laparoscopy to determine endometriosis prevalence, clinical stage, and type of lesion. DESIGN: A descriptive retrospective study of subjects who (1) were referred for the evaluation of chronic pelvic pain, (2) did not respond to a nonsteroidal anti-inflammatory drug and an oral contraceptive pill, and (3) underwent a laparoscopy to determine the etiology of the pelvic pain. SETTING:Patients referred to a surgical gynecologist in a pediatric/adolescent gynecology and reproductive endocrine academic practice. PARTICIPANTS: All patients younger than 22 years of age with chronic pelvic pain. INTERVENTION: Operative laparoscopy to determine the etiology of the chronic pelvic pain. MAIN OUTCOME MEASURES: Operative laparoscopy results including stage and description of endometriosis. RESULTS: More than two thirds of the study population (69.6%) was found to have endometriosis. All subjects had either stage I or II as determined by the American Fertility Society's classification system. The nature of the pain in the 32 subjects with endometriosis was both acyclic and cyclic in 20 (62.5%), acyclic only in 9 (28.1%), and cyclic only in 3 (9.4%). Other presenting symptoms included gastrointestinal in 11 (34.3%), urinary in 4 (12.5%), and irregular menses in 3 (9.4%). CONCLUSIONS: Adolescents with chronic pelvic pain not responding to medical therapy have a high rate of endometriosis and should be referred to a gynecologist who is experienced with the subtle laparoscopic findings of atypical endometriosis to diagnose the etiology of the pelvic pain and initiate appropriate therapy.
Authors: Amy D DiVasta; Henry A Feldman; Jenny Sadler Gallagher; Natalie A Stokes; Marc R Laufer; Mark D Hornstein; Catherine M Gordon Journal: Obstet Gynecol Date: 2015-09 Impact factor: 7.661
Authors: C Matthew Peterson; Erica B Johnstone; Ahmad O Hammoud; Joseph B Stanford; Michael W Varner; Anne Kennedy; Zhen Chen; Liping Sun; Victor Y Fujimoto; Mary L Hediger; Germaine M Buck Louis Journal: Am J Obstet Gynecol Date: 2013-02-27 Impact factor: 8.661
Authors: Peter A W Rogers; G David Adamson; Moamar Al-Jefout; Christian M Becker; Thomas M D'Hooghe; Gerard A J Dunselman; Asgerally Fazleabas; Linda C Giudice; Andrew W Horne; M Louise Hull; Lone Hummelshoj; Stacey A Missmer; Grant W Montgomery; Pamela Stratton; Robert N Taylor; Luk Rombauts; Philippa T Saunders; Katy Vincent; Krina T Zondervan Journal: Reprod Sci Date: 2016-09-27 Impact factor: 3.060