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Title: When you see nothing at all: Outcomes following a negative laparoscopy. A systematic review.
Austin Authors: Steele, Lucy A;Mooney, Samantha S;Gilbee, Ebony S;Grover, Sonia R 
Affiliation: University of Melbourne Clinical School
Department of Endosurgery, Mercy Hospital for Women, Victoria, Melbourne, Australia.
Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia.
Issue Date: 22-Sep-2023
Date: 2023
Publication information: The Australian & New Zealand Journal of Obstetrics & Gynaecology 2023-09-22
Abstract: 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. 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. 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. 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. 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.
DOI: 10.1111/ajo.13749
ORCID: 0000-0002-6414-5722
Journal: The Australian & New Zealand Journal of Obstetrics & Gynaecology
PubMed URL: 37737451
ISSN: 1479-828X
Type: Journal Article
Subjects: chronic pain
pelvic pain
Appears in Collections:Journal articles

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