This paper presents a review of 90 women with at least 6 months of chronic pelvic pain who were treated with adhesiolysis alone. Women who had other pathology were not included.
Adhesiolysis was performed laparoscopically using Metzenbaum scissors to divide the adhesions and the Surgiflex R Wave™ suction irrigation system with BICAP bipolar diathermy probe (ACMI, USA) were used for irrigation and hemostasis. Future adhesions were minimized by using hydroflotation with heparinized saline or 4% icodextrin.
Persistent pelvic pain, as measured on visual analog scales, and quality of life, as measured using an EQ-5D questionnaire, were assessed using mailed questionnaires and by telephone interview. Seventy-six women returned the questionnaires. Seven patients had moved away, so there were 69 patients available for analysis. Overall, 74% of women reported at least some improvement in pain symptoms (no pain, n = 12; great improvement, n = 26; a little improvement, n = 13; no change in pain, n = 12; and worse pain, n = 6).
Women with persistent pain reported a score of 45 (scale of 100) for dysmenorrhea, 28 for dyspareunia, 28 for dyschezia, and 29 for chronic pain. Overall, quality-of-life scores remained below the national average, but women who had great improvement or complete resolution of their pain had normal quality-of-life scores.
There was no difference in pain scores of women who were less than or more than 24 months postsurgery. No patients had significant complications.
