When you see nothing at all: Outcomes following a negative laparoscopy. A systematic review.

Publisher: Wiley-Blackwell Country of Publication: Australia NLM ID: 0001027 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1479-828X (Electronic) Linking ISSN: 00048666 NLM ISO Abbreviation: Aust N Z J Obstet Gynaecol

Publication: Melbourne : Wiley-Blackwell
Original Publication: Melbourne : Royal Australian and New Zealand College of Obstetricians and Gynaecologists

Laparoscopy* ; Pelvic Pain*/etiology ; Pelvic Pain*/surgery ; Quality of Life*; Humans ; Female ; Patient Satisfaction

Background: Persistent pelvic pain (PPP) is a complex and often debilitating condition. While widely accepted to be multifactorial in nature, the precise aetiology of PPP remains elusive. In many cases, women who undergo laparoscopy for PPP will have no visible pathology identified (a 'negative' laparoscopy). Currently, there are no consensus guidelines which outline the recommended management following a negative laparoscopy, and the woman's experiences and outcomes are not widely known.
Aims: This review aims to identify and summarise the literature surrounding the experiences of women with PPP who have a negative laparoscopy; specifically, their outcomes of pain, quality of life (QoL), satisfaction with care, and their overall management.
Materials and Methods: A systematic search of the electronic databases Ovid Medline, PubMed and Embase was performed. Studies in English exploring the outcomes of women with PPP following a negative laparoscopy were included.
Results: Four studies consisting of a total of 200 women were included. Results were inconsistent. Three studies concluded that the majority of women with PPP had persistent pain following a negative laparoscopy. A single study found that pain significantly improved after negative laparoscopy. QoL outcomes varied, with two studies reporting a positive impact and two studies reporting a deleterious impact on QoL following a negative laparoscopy.
Conclusions: The impact on pain outcomes and QoL following a laparoscopy that does not diagnose pathology remains unknown, and the available evidence is insufficient to guide evidence-based practice. This review highlights a significant gap in our understanding of surgical management for PPP.
(© 2023 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Obstetricians and Gynaecologists.)

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Keywords: chronic pain; endometriosis; female; laparoscopy; pelvic pain

Date Created: 20230922 Date Completed: 20240807 Latest Revision: 20240920

20240921

10.1111/ajo.13749

37737451