The DOI matches its Crossref record.
The Role of Laparoscopy in Chronic Pelvic Pain: Promise and Pitfalls
Abstract
Published studies relating to the usefulness of diagnostic and operative laparoscopy in women with chronic pelvic pain (CPP) were reviewed. This revealed that approximately 40 per cent of all laparoscopies were done for CPP. However, the definition of CPP was found to be nebulous and inconsistent, and that muddled definitive conclusions about patient diagnoses and treatments. The following definition of CPP was proposed: nonmenstrual pain of 3 or more months duration that localizes to the anatomic pelvis and is severe enough to cause functional disability and require medical or surgical treatment. A survey of published reports showed laparoscopically diagnosable abnormalities in 61 per cent of patients, compared with abnormalities in 28 per cent of women without CPP. Studies in adolescents were also reviewed and showed that adolescents with CPP also had significant laparoscopically diagnosed abnormalities, with 78 per cent showing some pathology, especially endometriosis (40 per cent). Endometriosis, pelvic adhesions, chronic pelvic inflammatory disease, and ovarian cysts were the diagnoses most commonly made via laparoscopy in CPP patients. The potential roles of each of these abnormalities in CPP were discussed, as well as the results of laparoscopic treatment of each disease. Laparoscopy was also found to have a limited role in women with CPP after hysterectomy or bilateral salpingo-oophorectomy, with usefulness in diagnosing and treating adhesions and residual ovary syndrome, although its role in ovarian remnant syndrome was uncertain. Overall, the data showed that less than 50 per cent of women with CPP were helped by diagnostic and operative laparoscopy, stressing the need for both physicians and patients to recognize that laparoscopy is neither the ultimate evaluation nor the panacea for CPP.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“among women who undergo laparoscopy, endometriosis is found in one-third who undergo surgery for CPP, compared with only 5% of those who do not have infertility or CPP”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Howard, 1993
Citations
Cited by
Sorted by citations
Latthe, P. M., Latthe, M., Say, L., Gülmezoglu, M., & Khan, K. S. (2006) · BMC Public Health · doi:10.1186/1471-2458-6-177 · Cited by 764
Factors predisposing women to chronic pelvic pain: systematic review
Latthe, P. M., Mignini, L. E., Gray, R. G., Hills, R. K., & Khan, K. S. (2006) · BMJ · doi:10.1136/bmj.38748.697465.55 · Cited by 591
Endometriosis and pelvic pain: epidemiological evidence of the relationship and implications
Fauconnier, A., & Chapron, C. (2005) · Human Reproduction Update · doi:10.1093/humupd/dmi029 · Cited by 522
“Definition of chronic pelvic pain symptoms and potential bias related to it There is considerable variety in the definition of chronic pelvic pain (Howard, 1993).”
BackgroundInfluentialHoward, F. M. (2003) · Obstetrics and Gynecology · doi:10.1016/s0029-7844(02)02723-0 · Cited by 487
“Chronic pelvic pain is nonmenstrual pelvic pain of 6 or more months duration that is severe enough to cause functional disability or require medical or surgical treatment.(1) It is a common and significant disorder of women.”
BackgroundSelf-citationChronic pelvic pain and endometriosis: translational evidence of the relationship and implications
Stratton, P., & Berkley, K. J. (2011) · Human Reproduction Update · doi:10.1093/humupd/dmq050 · Cited by 442
“CPP often debilitates women with endometriosis for years (Sinaii et al., 2007), has a high risk of emergency department visits (Gao et al., 2006), and is associated with time lost from work and significant physical and social debility (Simoens et al., 2007).”
BackgroundInfluentialSwank, D., Swank-Bordewijk, S. C. G., Hop, W., van Erp, W., Janssen, I. M. C., Bonjer, H. J., & Jeekel, J. J. (2003) · The Lancet · doi:10.1016/s0140-6736(03)12979-0 · Cited by 347
Heim, C., Ehlert, U., Hanker, J. P., & Hellhammer, D. H. (1998) · Psychosomatic Medicine · doi:10.1097/00006842-199805000-00017 · Cited by 309
“The prevalence of the frequent gynecological syndrome varies between 2 and 24%, and it is estimated that CPP accounts for up to 10% of gynecological consultations and 40% of diagnostic laparoscopies performed in general hospitals (2-4).”
BackgroundChronic pelvic pain in the community—Symptoms, investigations, and diagnoses
Zondervan, K. T., Yudkin, P. L., Vessey, M. P., Jenkinson, C., Dawes, M. G., Barlow, D. H., & Kennedy, S. (2001) · American Journal of Obstetrics and Gynecology · doi:10.1067/mob.2001.112904 · Cited by 278
As-Sanie, S., Harris, R. E., Napadow, V., Kim, J., Neshewat, G., Kairys, A., Williams, D., Clauw, D. J., & Schmidt-Wilcke, T. (2012) · Pain · doi:10.1016/j.pain.2012.01.032 · Cited by 268
“It is the primary indication for 10% of outpatient gynecology visits, 40% of diagnostic laparoscopies, and 12-17% of hysterectomies performed annually [19;46].”
Ling, F. (1999) · Obstetrics & Gynecology · doi:10.1016/s0029-7844(98)00341-x · Cited by 222
Endometriosis and Mechanisms of Pelvic Pain
Howard, F. M. (2009) · Journal of Minimally Invasive Gynecology · doi:10.1016/j.jmig.2009.06.017 · Cited by 218
“For example, in women who undergo laparoscopy to evaluate chronic pelvic pain (CPP), endometriosis is found in at least 33%, compared with 5% in women who undergo laparoscopy but do not have pain or infertility [9].”
BackgroundSelf-citationWu, Y., Strawn, E., Basir, Z., Halverson, G., & Guo, S.-W. (2007) · Fertility and Sterility · doi:10.1016/j.fertnstert.2006.05.077 · Cited by 193
Lower, A. M. (2004) · Human Reproduction · doi:10.1093/humrep/deh321 · Cited by 188
“They are also associated with substantial morbidity, constituting one of the most common causes of pelvic pain in women (Mishell and Davajan, 1991; Howard, 1993; Duffy and diZerega, 1996; Diamond and Freeman, 2001).”
InfluentialCombined hysteroscopic and laparoscopic findings in patients with chronic pelvic pain
Carter, J. E. (1994) · The Journal of the American Association of Gynecologic Laparoscopists · doi:10.1016/s1074-3804(05)80830-8 · Cited by 175
Pain typology and incident endometriosis
Schliep, K. C., Mumford, S. L., Peterson, C. M., Chen, Z., Johnstone, E. B., Sharp, H. T., Stanford, J. B., Hammoud, A. O., Sun, L., & Buck Louis, G. M. (2015) · Human Reproduction · doi:10.1093/humrep/dev147 · Cited by 164
“Indeed, based on one review article, 40% of gynecologic laparoscopies are due to chronic pelvic pain, a finding very close to what we observed in our study (Howard, 1993) but an often-cited statistic that was in need of revisiting with a more contemporary clinical population.”
ResultThe Prevalence of Endometriosis in Women with Chronic Pelvic Pain
Guo, S., & Wang, Y. (2006) · Gynecologic and Obstetric Investigation · doi:10.1159/000093019 · Cited by 167
Okaro, E., Condous, G. S., Khalid, A., Timmerman, D., Ameye, L., Huffel, S., & Bourne, T. (2006) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.2006.00849.x · Cited by 163
Non-surgical interventions for the management of chronic pelvic pain
Cheong, Y. C., Smotra, G., & Williams, A. C. D. C. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd008797.pub2 · Cited by 152
DANIELS, J. P., & Khan, K. S. (2010) · BMJ · doi:10.1136/bmj.c4834 · Cited by 151
RETIRED: Consensus Guidelines for the Management of Chronic Pelvic Pain
Jarrell, J. F., Vilos, G. A., Allaire, C., Burgess, S., Fortin, C. A., Gerwin, R. D., Lapensée, L., Lea, R. H., Leyland, N. A., Martyn, P., et al. (2005) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/s1701-2163(16)30993-8 · Cited by 150
Trauma and Posttraumatic Stress Disorder in Women With Chronic Pelvic Pain
Meltzer-Brody, S. E., Leserman, J., Zolnoun, D., Steege, J. F., Green, E., & Teich, A. (2007) · Obstetrics and Gynecology · doi:10.1097/01.aog.0000258296.35538.88 · Cited by 143
DANIELS, J. P. (2009) · JAMA · doi:10.1001/jama.2009.1268 · Cited by 142
Champaneria, R., Shah, L., Moss, J. G., Gupta, J. K., Birch, J. V., Middleton, L., & DANIELS, J. P. (2016) · Health Technology Assessment · doi:10.3310/hta20050 · Cited by 137
Chapron, C., Barakat, H., Fritel, X., Dubuisson, J.-B., Bréart, G., & Fauconnier, A. (2004) · Human Reproduction · doi:10.1093/humrep/deh627 · Cited by 136
“The second limitation is that the diagnosis of posterior DIE was based on laparoscopic evaluation (The American Fertility Society, 1993) and not on histological results, as some authors recommend (Howard, 1993; Redwine, 1999).”
Janda, A. M., As‐Sanie, S., Rajala, B., Tsodikov, A., Moser, S. E., Clauw, D. J., & Brummett, C. M. (2015) · Anesthesiology · doi:10.1097/aln.0000000000000637 · Cited by 132
Verco, S. J. (2000) · Human Reproduction · doi:10.1093/humrep/15.8.1764 · Cited by 128
Chronic pelvic pain: aetiology and therapy
Cheong, Y. C., & Stones, W. R. (2006) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2006.04.004 · Cited by 128
Conventional Medical Therapies for Endometriosis
Rice, V. M. (2002) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2002.tb02795.x · Cited by 127
Johns, D. B., Keyport, G. M., Hoehler, F. K., et al. (2001) · Fertility and Sterility · doi:10.1016/s0015-0282(01)01954-9 · Cited by 127
Collett, B. J., Cordle, C. J., Stewart, C. R., & Jagger, C. (1998) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1998.tb09356.x · Cited by 121
Pelvic Congestion Syndrome: Systematic Review of Treatment Success
Rizer, M., Alexander, R., Sharpe, E., Rochon, P. J., & Brown, C. (2018) · Seminars in Interventional Radiology · doi:10.1055/s-0038-1636519 · Cited by 119
The role of laparoscopy in the management of pelvic pain in women of reproductive age
Porpora, M. G., & Gomel, V. (1997) · Fertility and Sterility · doi:10.1016/s0015-0282(97)00192-1 · Cited by 111
Ovarian Varices in Healthy Female Kidney Donors: Incidence, Morbidity, and Clinical Outcome
Belenky, A., Bartal, G., Atar, E., Cohen, M., & Bachar, G. N. (2002) · American Journal of Roentgenology · doi:10.2214/ajr.179.3.1790625 · Cited by 115
Adhesions in patients with chronic pelvic pain: A role for adhesiolysis?
Hammoud, A. O., Gago, L. A., & Diamond, M. P. (2004) · Fertility and Sterility · doi:10.1016/j.fertnstert.2004.07.948 · Cited by 114
Prevalence of Endometriosis During Abdominal or Laparoscopic Hysterectomy for Chronic Pelvic Pain
Mowers, E. L., Lim, C. S., Skinner, B. D., Mahnert, N. D., Kamdar, N. S., Morgan, D. M., & As‐Sanie, S. (2016) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000001422 · Cited by 110
Wingenfeld, K., Heim, C. C., Schmidt, I., Wagner, D., Meinlschmidt, G., & Hellhammer, D. H. (2007) · Psychosomatic Medicine · doi:10.1097/psy.0b013e31815ff3ce · Cited by 112
Epidemiology of chronic pelvic pain
Zondervan, K. T., & Barlow, D. H. (2000) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1053/beog.1999.0083 · Cited by 113
The effectiveness of hysterectomy for chronic pelvic pain
DHILLIS, S., AMARCHBANKS, P., & BPETERSON, H. (1995) · Obstetrics and Gynecology · doi:10.1016/0029-7844(95)00304-a · Cited by 108
Crosslinked hyaluronan hydrogels containing mitomycin C reduce postoperative abdominal adhesions
Liu, Y., Li, H., Shu, X. Z., et al. (2005) · Fertility and Sterility · doi:10.1016/j.fertnstert.2004.09.038 · Cited by 102
The role of laparoscopy as a diagnostic tool in chronic pelvic pain
Howard, F. M. (2000) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1053/beog.1999.0086 · Cited by 96
Self-citationLaparoscopic management of small bowel obstruction: indications and outcome
León, E. L.-D., Metzger, A., Tsiotos, G. G., et al. (1998) · Journal of Gastrointestinal Surgery · doi:10.1016/s1091-255x(98)80003-6 · Cited by 98
Biomaterials to Prevent Post-Operative Adhesion
Park, H., Baek, S., Kang, H., & Lee, D. (2020) · Materials · doi:10.3390/ma13143056 · Cited by 96
Johns, D. B., Rodgers, K. E., Donahue, W. D., Kiorpes, T. C., & diZerega, G. S. (1997) · Fertility and Sterility · doi:10.1016/s0015-0282(97)81472-0 · Cited by 94
(2005) · PubMed Central · Cited by 91
Does mindfulness meditation improve chronic pain? A systematic review
Ball, E. F., Nur Shafina Muhammad Sharizan, E., Franklin, G., & Rogozińska, E. (2017) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/gco.0000000000000417 · Cited by 91
Chronic Pelvic Pain as a Somatoform Disorder
Ehlert, U., Heim, C. C., & Hellhammer, D. H. (1999) · Psychotherapy and Psychosomatics · doi:10.1159/000012318 · Cited by 91
Ultrasound Evaluation of Gynecologic Causes of Pelvic Pain
Cicchiello, L. A., Hamper, U. M., & Scoutt, L. M. (2011) · Obstetrics and Gynecology Clinics of North America · doi:10.1016/j.ogc.2011.02.005 · Cited by 90
Howard, F. M. (1996) · The Journal of the American Association of Gynecologic Laparoscopists · doi:10.1016/s1074-3804(96)80116-2 · Cited by 88
Self-citationThe Role of Laparoscopy in the Chronic Pelvic Pain Patient
HOWARD, F. M. (2003) · Clinical Obstetrics and Gynecology · doi:10.1097/00003081-200312000-00004 · Cited by 84
“copy by gynecologists when evaluating women with chronic pelvic pain—more than 40% of gynecologic diagnostic laparoscopies are done for chronic pelvic pain.(7) In fact, gynecologists often consider laparoscopy a routine part of the evaluation.”
BackgroundSelf-citationAbdominal adhesion prevention: Still a sticky subject
Lauder, C. I. W., Garcea, G., Strickland, A., & Maddern, G. J. (2010) · Digestive Surgery · doi:10.1159/000314805 · Cited by 89
The non-human primate model of endometriosis: research and implications for fecundity
Braundmeier, A. G., & Fazleabas, A. T. (2009) · Molecular Human Reproduction · doi:10.1093/molehr/gap057 · Cited by 85
Focus on Primary Care: Chronic Pelvic Pain in Women
Gelbaya, T. A., & Elhalwagy, H. (2001) · Obstetrical & Gynecological Survey · doi:10.1097/00006254-200112000-00002 · Cited by 86
Chronic Pelvic Pain in Women: An Epidemiological Perspective
Ayorinde, A., Macfarlane, G. J., Saraswat, L., & Bhattacharya, S. (2015) · Women s Health · doi:10.2217/whe.15.30 · Cited by 86
Moore, J. A., & Kennedy, S. (2000) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1053/beog.1999.0082 · Cited by 88
Smoking habits of 411 women with histologically proven endometriosis and 567 unaffected women
Chapron, C., de Souza, C. A. B., de Ziegler, D., Lafay-Pillet, M.-C., Ngô, C., Bijaoui, G., Goffinet, F., & Borghese, B. (2010) · Fertility and Sterility · doi:10.1016/j.fertnstert.2010.04.020 · Cited by 84
Documenting the Current Definitions of Chronic Pelvic Pain: Implications for Research
Williams, R. E., Hartmann, K. E., & Steege, J. F. (2004) · Obstetrics and Gynecology · doi:10.1097/01.aog.0000115513.92318.b7 · Cited by 85
“Chronic pelvic pain may originate from 1 or more organ systems or pathologies and may have multiple contributing factors.(1,2) Chronic pelvic pain is prevalent in 12– 39% of women, depending on the definition used and population studied,(1,3,4) who use 3 times more medications, have 4 times more nongynecologic operati…”
BackgroundConsensus Guidelines for the Management of Chronic Pelvic Pain
Jarrell, J. F., Vilos, G. A., Allaire, C., Burgess, S., Fortin, C. A., Gerwin, R. D., Lapensée, L., Lea, R. H., Leyland, N. A., Martyn, P., et al. (2005) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/s1701-2163(16)30732-0 · Cited by 81
Stanford, E. J., Koziol, J. A., & Feng, A. C. (2005) · Journal of Minimally Invasive Gynecology · doi:10.1016/j.jmig.2004.12.016 · Cited by 76
Solnik, M. J., & Siedhoff, M. T. (2015) · Springer eBooks · doi:10.1007/978-3-319-21587-7_12 · Cited by 77
RETIRED: No. 164-Consensus Guidelines for the Management of Chronic Pelvic Pain
Jarrell, J. F., Vilos, G. A., Allaire, C., Burgess, S., Fortin, C. A., Gerwin, R. D., Lapensée, L., Lea, R. H., Leyland, N. A., Martyn, P., et al. (2018) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/j.jogc.2018.08.015 · Cited by 82
Physical therapy in the management of women with chronic pelvic pain
Montenegro, M. L., de Vasconcelos, E. C. L. M., dos Reis, F. J. C., Nogueira, A., & Poli‐Neto, O. B. (2007) · International Journal of Clinical Practice · doi:10.1111/j.1742-1241.2007.01530.x · Cited by 78
Lamvu, G., Williams, R. E., Zolnoun, D., Wechter, M. E., Shortliffe, A., Fulton, G., & Steege, J. F. (2006) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2006.03.081 · Cited by 73
Bruner‐Tran, K. L., Mokshagundam, S., Herington, J. L., Ding, T., & Osteen, K. G. (2018) · Current Women s Health Reviews · doi:10.2174/1573404813666170921162041 · Cited by 80
“Unfortunately, the side effects of hormonal therapy for endometriosis cause many women to abandon this treatment; nevertheless, surgical treatment alone is frequently non-curative and many women suffer recurrence [24-32].”
BackgroundSteege, J. F., & Siedhoff, M. T. (2014) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000000417 · Cited by 72
“Early reviews supported the role of adhesions as a significant contributor in chronic pelvic pain.(10,22) More recent investigations(23) demonstrate a relatively weak correlation between adhesions and chronic pelvic pain, much less than other factors such as psychosomatic symptoms and substance abuse.”
BackgroundMedical management of endometriosis
Peckham, B. M. (2000) · International Journal of Gynecology & Obstetrics · doi:10.1016/s0020-7292(00)80034-x · Cited by 73
Thornton, M. H., Johns, D. B., Campeau, J. D., et al. (1998) · Human Reproduction · doi:10.1093/humrep/13.6.1480 · Cited by 72
Roset, E., Boulvain, M., & Irion, O. P. (2003) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/s0301-2115(02)00366-4 · Cited by 70
“A significant proportion of women suffering from chronic abdominal pain have peritoneal adhesions [16].”
BackgroundAssociation between chronic pelvic pain symptoms and the presence of endometriosis
Apostolopoulos, N. V., Alexandraki, K., Gorry, A., & Coker, A. (2015) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-015-3855-2 · Cited by 66
“It has been reported that two-thirds of patients who undergo laparoscopy for CPP will not have endometriosis [3].”
BackgroundLaparoscopic appendectomy in patients with endometriosis
Berker, B., LaShay, N., Davarpanah, R., Marziali, M., Nezhat, C. H., & Nezhat, C. (2005) · Journal of Minimally Invasive Gynecology · doi:10.1016/j.jmig.2005.03.003 · Cited by 66
Nakagawa, H., Matsumoto, Y., Matsumoto, Y., Miwa, Y., & Nagasaki, Y. (2015) · Biomaterials · doi:10.1016/j.biomaterials.2015.08.018 · Cited by 67
DeWilde, R. L., Trew, G. H., & on behalf of the Expert Adhesions Working Party of the European Society of Gynaecological Endoscopy (ESGE) (2007) · Gynecological Surgery · doi:10.1007/s10397-007-0338-x · Cited by 67
“While retrospective and prospective studies have shown improvement in 50–90% of cases after laparoscopic adhesiolysis [63–68], only very few studies fulfilled the conditions of a controlled or even prospective randomised design.”
BackgroundEndometriosis and the Fallopian Tubes: Theories of Origin and Clinical Implications
Hill, C. J., Fakhreldin, M., Maclean, A., Dobson, L., Nancarrow, L., Bradfield, A., Choi, F., Daley, D., Tempest, N., & Hapangama, D. K. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9061905 · Cited by 70
Reduction of postoperative adhesion formation after laparoscopic ovarian cystectomy
Keckstein, J., Ulrich, U. A., Sasse, V., et al. (1996) · Human Reproduction · doi:10.1093/humrep/11.3.579 · Cited by 65
“This is of particular interest not only because the ovary is primarily involved in reproductive function and post-surgical pain (Steege and Stout, 1991; Howard, 1993; Steege et al, 1993; Oelsner et al, 1994), but also because the ovary is the most common site for adhesion formation (Diamond et al, 1987).”
BackgroundLeserman, J., Zolnoun, D., Meltzer-Brody, S., Lamvu, G., & Steege, J. F. (2006) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2006.03.071 · Cited by 62
“007); (2) fibroid pain onphysical functioning (P ! .”
BackgroundMethodResultInfluentialRodgers, K. E., Schwartz, H. E., Roda, N., Thornton, M. H., Kobak, W. H., & diZerega, G. S. (2000) · Fertility and Sterility · doi:10.1016/s0015-0282(99)00642-1 · Cited by 60
Current Approaches to Optimizing the Treatment of Endometriosis in Adolescents
Laufer, M. R. (2008) · Gynecologic and Obstetric Investigation · doi:10.1159/000148027 · Cited by 59
“The pelvis is filled with irrigation fluid, and then the laparoscope is submerged, with evaluation of the pelvic peritoneum through the liquid medium. This technique enables the viewer to appreciate the three-dimensional configuration of the lesions and to exclude light reflection as a possible etiology. Peritoneal de…”
BackgroundBall, E., & Khan, K. S. (2020) · F1000Research · doi:10.12688/f1000research.20750.1 · Cited by 58
Reduction of post-surgical adhesions with ferric hyaluronate gel: a European study
Lundorff, P., van Geldorp, H. J., Tronstad, S., Lalos, O., Larsson, B., Johns, D. B., & diZerega, G. S. (2001) · Human Reproduction · doi:10.1093/humrep/16.9.1982 · Cited by 55
“Adhesion formation after peritoneal surgery is a major cause of post-operative bowel obstruction, infertility and chronic pelvic pain (Miller and Winfield, 1959; Bronson and Wallach, 1977; Kresch et al., 1984; Steege et al., 1991; Howard, 1993; Strickler et al., 1994; Tulandi et al., 1998).”
BackgroundPharmacological Management of Chronic Pelvic Pain in Women
Carey, E. T., Till, S. R., & As‐Sanie, S. (2017) · Drugs · doi:10.1007/s40265-016-0687-8 · Cited by 57
Clinical Outcome in Female Patients with Pelvic Pain and Normal Pelvic US Findings
Harris, R. D., Holtzman, S. R., & Poppe, A. M. (2000) · Radiology · doi:10.1148/radiology.216.2.r00au22440 · Cited by 55
Fuentes-Márquez, P., Cabrera-Martos, I., & Valenza, M. C. (2019) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2018.1472687 · Cited by 54
“This condition is responsible for 20% of all outpatient appointments in secondary care (Howard, 1993).”
BackgroundDiagnostic laparoscopy in chronic pelvic pain
Sharma, D., Dahiya, K., Duhan, N., et al. (2010) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-010-1354-z · Cited by 54
“It accounts for 10% of all referrals to gynecologists and forms the indication for 12% of all hysterectomies and over 40% of gynecological diagnostic laparoscopies [1].”
Valentin, L. (2006) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2006.06.001 · Cited by 52
Predictive factors for pain experienced at office fluid minihysteroscopy
Cicinelli, E., Rossi, A. C., Marinaccio, M., et al. (2007) · Journal of Minimally Invasive Gynecology · doi:10.1016/j.jmig.2007.03.008 · Cited by 52
Relations entre endométriose et algie pelvienne chronique : quel est le niveau de preuve ?
Fauconnier, A., Fritel, X., & Chapron, C. (2009) · Gynécologie Obstétrique & Fertilité · doi:10.1016/j.gyobfe.2008.08.016 · Cited by 50
Gynecological disorders in bladder pain syndrome/interstitial cystitis patients
Cervigni, M., & Natale, F. (2014) · International Journal of Urology · doi:10.1111/iju.12379 · Cited by 50
Management of Chronic Pelvic Pain
Shin, J. H., & Howard, F. M. (2011) · Current Pain and Headache Reports · doi:10.1007/s11916-011-0204-4 · Cited by 50
“CPP accounts for about 10% of all ambulatory referrals to a gynecologist, 20% of all hysterectomies performed for benign disease, and 40% of all gynecologic laparoscopies performed annually in the United States [1].”
BackgroundSelf-citationFactors Predisposing Women to Chronic Pelvic Pain: Systematic Review
(2006) · Obstetrics and Gynecology · doi:10.1097/01.aog.0000209492.35125.34 · Cited by 50
The role of laparoscopy in chronic and recurrent abdominal pain
Miller, K. A., Mayer, E., & MORITZ, E. (1996) · The American Journal of Surgery · doi:10.1016/s0002-9610(96)00187-0 · Cited by 47
Howard, F. M. (2000) · The Journal of the American Association of Gynecologic Laparoscopists · doi:10.1016/s1074-3804(05)60360-x · Cited by 47
Self-citationMilingos, S., Πρωτόπαπας, Α., Kallipolitis, G., Drakakis, P., Loutradis, D., Liapi, A., & Antsaklis, A. J. (2006) · Gynecologic and Obstetric Investigation · doi:10.1159/000092023 · Cited by 44
“Accordingly, treatment of endometriosis either with surgery or with medical ovarian suppression might not lead to the relief of patients from their pain [”
BackgroundContributions of physical and sexual abuse to women's experiences with chronic pelvic pain.
Poleshuck, E. L., Dworkin, R. H., Howard, F. M., Foster, D. C., Shields, C. G., Giles, D. E., & Tu, X. M. (2005) · PubMed · Cited by 46
Self-citationRodgers, K. E., Cohn, D., Hotovely, A., et al. (1998) · Fertility and Sterility · doi:10.1016/s0015-0282(97)00574-8 · Cited by 46
Laparoscopic Management of Patients with Endometriosis and Chronic Pelvic Pain
Milingos, S., Πρωτόπαπας, Α., Drakakis, P., Liapi, A., Loutradis, D., Kallipolitis, G., Milingos, D. S., & Michalas, S. S. (2003) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1290.030 · Cited by 44
Diagnosis of endometriosis and pelvic pain
Garry, R. (2006) · Fertility and Sterility · doi:10.1016/j.fertnstert.2006.06.045 · Cited by 43
The Emerging Presence of Interstitial Cystitis in Gynecologic Patients with Chronic Pelvic Pain
Stanford, E. J., Dell, J. R., & Parsons, C. L. (2007) · Urology · doi:10.1016/j.urology.2006.05.049 · Cited by 45
The search for genetic variants predisposing women to endometriosis
Di, W. J., & Guo, S. (2007) · Current Opinion in Obstetrics & Gynecology · doi:10.1097/gco.0b013e328235a5b4 · Cited by 43
Serum Antiendometrial Antibodies and Diagnosis of Endometriosis
Randall, G. W., Gantt, P. A., Poe‐Zeigler, R. L., Bergmann, C. A., Noel, M. E., Strawbridge, W. R., Richardson‐Cox, B., Hereford, J. R., & Reiff, R. H. (2007) · American Journal of Reproductive Immunology · doi:10.1111/j.1600-0897.2007.00523.x · Cited by 44
Evaluation of the efficacy of endovascular treatment of pelvic congestion syndrome
Hocquelet, A., Bras, Y. L., Balian, E., et al. (2013) · Diagnostic and Interventional Imaging · doi:10.1016/j.diii.2013.09.011 · Cited by 42
“Chronic pelvic ain accounts 10% of the gynaecological consultations [6] of hich PCS is reported to be the second leading cause, behind dhesions and ahead of endometriosis in non-nulliparous atients [7].”
BackgroundAgarwala, N., & Liu, C. Y. (2003) · The Journal of the American Association of Gynecologic Laparoscopists · doi:10.1016/s1074-3804(05)60292-7 · Cited by 43
Metadata
- Authors
- HOWARD, F. M.
- Affiliations
- University of Rochester Medicine (US)
- Corresponding author
- HOWARD, FRED M.
- Venue
- Obstetrical & Gynecological Survey
- Published
- 1993-06
- Volume
- 48
- Issue
- 6
- Pages
- 357-387
- ISSN
- 0029-7828 (ISSN-L)
- OpenAlex
- W2131501232
- Cited by
- 434
- References
- 0
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 6 · 2023: 8 · 2022: 6 · 2021: 11 · 2020: 10 · 2019: 17 · 2018: 16 · 2017: 15 · 2016: 9 · 2015: 18 · 2014: 25 · 2013: 6 · 2012: 22
- FWCI
- 6.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obstetrical & Gynecological Survey (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Surgery › Intestinal and Peritoneal Adhesions
- Keywords
- chronic pelvic pain, diagnostic laparoscopy, laparoscopic surgery, endometriosis, pelvic adhesions, chronic pelvic inflammatory disease, ovarian cysts, ovarian remnant syndrome, hysterectomy, salpingo-oophorectomy, adolescents
- MeSH terms
- Pelvic Inflammatory Disease, Chronic Disease, Endometriosis, Female, Genital Diseases, Female, Genital Neoplasms, Female, Humans, Ovarian Cysts, Pain, Pain Measurement, Postoperative Pain, Pelvis, Laparoscopy, Prospective Studies, Retrospective Studies
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
