Effect of tubal ligation on pelvic endometriosis externa in multiparous women with chronic pelvic pain
Cheewadhanaraks, S.
Journal of the Medical Association of Thailand 87(7): 735-739
2004
ISSN/ISBN: 0125-2208 PMID: 15521225 Document Number: 2246
Objective : To determine whether tubal ligation is associated with decreased prevalence and less severity of pelvic endometriosis in multiparous patients with chronic pelvic pain. Material and Method : From January 1995 to April 2002, 322 chronic pelvic pain patients underwent laparoscopy. Of these, 125 patients were multiparous (parity gtoreq12). Their obstetric history, present contraceptive methods and laparoscopic findings were recorded perioperatively. The medical record of each patient was reviewed and analyzed. Results : Among multiparous women with chronic pelvic pain, the prevalence of endometriosis in patients with and without tubal ligation was 45.1% (23 of 51 patients) and 59.5% (44 of 74 patients), respectively. Moderate-severe endometriosis was found in 8.7% (2 of 23 patients) and 36.4% (16 of 44 patients) among patients with and without sterilization. Tubal ligation was statistically significantly associated with severity of disease (P = 0.036, Crude OR (95% CI) = 0.17 (0.02-0.85), Adjusted OR (95% CI) = 0.21 (0.04-1.08)). There was no statistically significant relationship between tubal ligation and prevalence of endometriosis. The small sample size of the study might account for this statistical result. Conclusion : Nearly half of multiparous women with chronic pelvic pain and tubal ligation had endometriosis. Tubal ligation was related to less severity of disease, with statistically significant difference.
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