Primary chronic pelvic pain: laparoscopic fulguration of uterosacral ligaments vs. Observation only Hospital de San José, Bogotá DC. march 2008 to april 2010
Dolor pélvico crónico primario: fulguración laparoscópica de los ligamentos úterosacros vs. observación hospital de san José, Bogotá DC. marzo 2008 a abril 2010
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Abstract
Chronic pelvic pain (CPP) requires an adequate diagnosis and treatment. Surgical therapeutic options (ablation, fulguration of uterosacral ligaments and presacral neurectomy) as well as pharmacological treatments exist. Objective: we sought to compare the level of CPP of unknown etiology treated with laparoscopic fulguration of uterosacral ligaments with observation only, at Hospital de San José, Bogotá DC. Materials and Methods: a prospective cohort study by meaos of a pre-surgical visual analogous scale and follow-up at one, two and six month intervals after the laparoscopy was conducted between March 2008 and April 2010. Results: 69 patients were included, 28 in the fulguration group and 41 in the observation group. There were no intraoperative complications. The media of the pre-surgical Friedman test in the fulguration group was 8 (RIC:6-8) and the media of pelvic pain at six months was 3 (RIC:2-6) with a p-value of 0.001, showing statistic significance in pain improvement over time. The Mann-Whitney Wilcoxon test was used to assess differences between groups at six months obtaining a p-value of0.66, thus no difference between the media of pain in the two groups was observed. Conclusions: there is no significant difference on the improvement of pain between the two groups. Better results may be offered through longer follow-up periods and other surgical techniques.
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