Laparoscopic plication and suspension of the round ligament for chronic pelvic pain and dyspareunia.

Abstract

STUDY OBJECTIVE:

To describe a technique of uterine suspension using round ligaments to relieve pain in selected patients with various degrees of uterine retroversion.

DESIGN:

Prospective clinical study (Canadian Task Force classification II-2).

SETTING:

University-based center for reproductive medicine.

PATIENTS:

Thirty women who underwent laparoscopy for investigation of chronic pelvic pain (CPP) and dyspareunia.

INTERVENTION:

Round ligaments were plicated using a modification of intracorporeal knot tying during laparoscopy.

MEASUREMENTS AND MAIN RESULTS:

The extent of plication was planned to elevate the uterus and bring it minimally forward. Mean +/- SD operating time was 14+/-4 minutes. Pain scores before and after surgery were 4.5+/-1.0 and 1.6+/-0.6, respectively (p<0.001). There were no complications during or after surgery. Only three women had minimal dyspareunia postoperatively, although they had anteverted uteri. One patient had severe dyspareunia that developed 7 months after surgery and continued through the second year of follow-up. Nineteen women with anteverted uteri were free of dyspareunia after 2 years.

CONCLUSION:

Round ligament plication is safe and effective in patients with retroverted uteri and dyspareunia or CPP.

• Authors: S Batioglu, H B Zeyneloglu
• Journal: The Journal of the American Association of Gynecologic Laparoscopists (J Am Assoc Gynecol Laparosc) Vol. 7 Issue 4 Pg. 547-51 (Nov 2000) ISSN: 1074-3804 [Print] United States
• PMID: 11044511 (Publication Type: Clinical Trial, Journal Article)

Topics

• Adult
• Chronic Disease
• Dyspareunia (complications, diagnosis, surgery)
• Female
• Follow-Up Studies
• Humans
• Laparoscopy (methods)
• Middle Aged
• Pain Measurement
• Patient Satisfaction
• Pelvic Pain (complications, diagnosis, surgery)
• Prospective Studies
• Round Ligament of Uterus (physiopathology, surgery)
• Treatment Outcome