Emergency department attendances for persistent pelvic pain are not reduced following laparoscopic surgery for women with or without endometriosis.

Abstract

To explore the change in emergency department (ED) attendances for persistent pelvic pain (PPP) following laparoscopic treatment of endometriosis. A retrospective service evaluation was conducted on a convenience sample of 1 calendar year of elective gynaecological laparoscopies for PPP. Data were collected on ED visits for surgical complications, and for PPP in the 12 months prior to and following surgery. Of the 195 women undergoing laparoscopy, 30 had attended the ED owing to their PPP in the preceding year. Endometriosis was found and treated in 51% of the cohort and no cause for pain was found in the other 96 women. Eighteen women suffered postoperative complications. In the subsequent 12 months, 31 of the cohort attended the ED for PPP. Likelihood of unscheduled hospital visits for post-operative complications and for exacerbations of pain in the year prior to and following surgery was independent of the presence of endometriosis lesions. In a cohort of women living with PPP, laparoscopic surgery failed to reduce the need to attend the ED owing to their pain. Further investigation into interventions that can reduce the burden of pain on these women and the healthcare system is required.