Background. Many women who undergo diagnostic laparoscopy
for chronic pelvic pain do not have
pelvic pathology. This has led to an interest in psychological factors
that
might contribute to their
experience of pain. This study was designed to evaluate the effects of
diagnostic laparoscopy on
women with chronic pelvic pain and to explore possible psychological mechanisms.
Methods. Seventy-one women undergoing laparoscopy for chronic
pelvic pain were randomly
allocated to one of two groups waiting different lengths of time for
laparoscopy. Women were
interviewed before laparoscopy and were followed up 1 week, 3 months and
6 months afterwards.
Pain was assessed with an interview measure, diaries and visual analogue
scales.
Results. Pain reductions were observed from before to after
diagnostic laparoscopy. Regression
analysis was used to identify factors which predicted improvements in pain.
The hypothesis that
psychological factors would predict improvements in pain was confirmed.
Pain improvements after
laparoscopy were predicted by beliefs about pain and the change in each
woman's evaluation of the
seriousness of her condition. Other than baseline pain, these psychological
variables were the only
ones to emerge as predictors of pain change despite exploratory analysis
of over 40 other variables.
Conclusions. Diagnostic laparoscopy can have beneficial
effects in women with chronic pelvic pain.
These effects appear to be the result of psychological mechanisms.
Further investigation of these
mechanisms could help in the understanding and treatment of women with
chronic pelvic pain.