Minimally Invasive Surgery and Chronic Pelvic Pain

Objective: The minimally invasive surgical treatment options for many chronic pelvic pain disorders are reviewed, including treatments for endometriosis, ovarian remnant syndrome, pelvic congestion, post-ablation pain, pelvic adhesions, and uterine retroversion. Design: A systematic review of the literature referring to surgical treatments of chronic pelvic pain, with emphasis on articles published after 1990. Data Sources: Medline searches for terms including the specific chronic pain syndromes and “surgery,” “treatment,” or “management.” Eligibility Criteria: Trials, prospective and observational studies, and reviews assessing the treatment efficacy of surgical modalities employed in the treatment of chronic pelvic pain conditions were considered. Only English-language articles were included. Results: The indications, efficacy, risks, and benefits of minimally invasive treatments for each chronic pelvic pain condition are discussed. Conclusion: There are well-defined minimally invasive surgical treatment options for each chronic pelvic pain condition reviewed. There are limitations of available literature, both in level of evidence and quantity. Most studies are confounded by the multifactorial nature of chronic pelvic pain. Keywords: Minimally invasive surgery, chronic pelvic pain, laparoscopy, endometriosis, adhesions, pelvic congestion.