Avtor/Urednik     Domazet-Fink, Jadranka; Kobal, Borut
Naslov     Vloga laparoskopije pri odkrivanju vzrokov kronične pelvične bolečine
Prevedeni naslov     The role of laparoscopy in discovering the causes of chronic pelvic pain
Tip     članek
Vir     Zdrav Vestn
Vol. in št.     Letnik 72, št. Suppl 2
Leto izdaje     2003
Obseg     str. II-139-42
Jezik     slo
Abstrakt     Background. The aim of this study was to assess the share of organic changes in patients with chronic pelvic pain (CPP) as well as evaluate the need for invasive CPP diagnostics - laparoscopy. Methods. The data for the analysis were gathered retrospectively from the descriptions of 287 CPP patients who were treated at the Clinic of Gynaecology in Ljubljana from 1993 to 1999. In this analysis the share of laparoscopically established organic causes of CPP was assessed and the findings of invasive (laparoscopy) and non-invasive diagnostics (clinical status and ultrasound) were compared. Results. Out of 287 patients, 272 underwent laparoscopy, 7 underwent laparotomy while 8 were only observed. As regards organic CPP causes, an organic cause was established in 70.7% patients through laparoscopy. The most frequently observed phenomena were adhesions, namely in 97 (35.7%) patients, endometriosis in 68 (25.0%) and pelvic varices in 29 (10%) patients. By comparing the results of invasive and non-invasive diagnostics it was established that up to three times more organic changes - a possible cause of CPP - can be discovered through laparoscopy than through the use of non-invasive diagnostics methods. Conclusions. Laparoscopy is considered to be the most reliable method of diagnostics and detection of organic causes of CPP. An adequate psychological treatment within a multidisciplinary approach is necessary in patients in whom an organic cause of CPP can not be discovered in their genital tract.
Izvleček     Izhodišča. Namen analize je bil ugotoviti delež organskih sprememb pri bolnicah s kronično pelvično bolečino (KPB) in ovrednotiti potrebo po invazivni diagnostiki - laparoskopiji. Metode. Podatke za analizo smo zajeli retrospektivno iz popisov 287 bolnic s KPB, ki so bile zdravljene na Ginekološki kliniki v Ljubljani v obdobju 1993 do 1999. V analizi smo ocenili delež laparoskopsko ugotovljenih organskih vzrokov za KPB in primerjali ugotovitve invazivne (laparoskopija) in neinvazivne diagnostike (klinični status in UZ). Rezultati. Od 287 bolnic je bilo 272 laparoskopiranih, 7 laparotomiranih in 8 samo opazovanih. Med organskimi vzroki za KPB smo z laparoskopijo organski vzrok ugotovili pri 70,7% bolnic. Najpogosteje smo ugotovili zarastline pri 97 (35,7%) bolnicah, endometriozo pri 68 (25,0%) in pelvične varice pri 29 (10%) bolnicah. Ob primerjanju rezultatov invazivne in neinvazivne diagnostike smo ugotovili, da z laparoskopijo odkrijemo do trikrat več organskih sprememb, ki so lahko vzrok KPB, kot pa samo z metodami neinvazivne diagnostike. Zaključki. Laparoskopija predstavlja najzanesljivejši način diagnostike odkrivanja organskih vzrokov KPB. Pri bolnicah, pri katerih na rodilih ne odkrijemo organskega vzroka za KPB, je v smislu multidisciplinarnega pristopa potrebna ustrezna psihoterapevtska obravnava.
Deskriptorji     PELVIC PAIN
LAPAROSCOPY
RISK FACTORS