Intravesicular pain mapping.

The lack of success with the physician-only approach to bladder pain and interstitial cystitis demonstrates the need for a fresh new method. Such an approach, in which the patient becomes an integral part of the operating team, verifying that the operative findings are the source of the pain and that treatment of these areas will lead to the resolution of the pain, needs to be examined further.

Pain referral patterns in the pelvis.

Study Objective: To determine if right-left pelvic pain orientation exists in all patients, and to estimate the frequency of pain referral patterns in the pelvis.

Design: Prospective, nonrandomized trial (Canadian Task Force classification II-1).

Setting: University-affiliated hospital.

Effect on negative laparoscopy rate in chronic pelvic pain patients using patient assisted laparoscopy.

Objective: To determine the value of Patient Assisted Laparoscopy (PAL) in the diagnosis of pelvic pain.

Methods: One hundred patients with pelvic pain were assessed by the procedure of Patient Assisted Laparoscopy to determine the cause of chronic pelvic pain.

Results: Of the 100 patients with pelvic pain, 12 patients were not assessed due to technique failure, which included reaction to the carbon dioxide gas, inadequate visualization due to abdominal adhesions or failure to enter peritoneum.

Patient-Assisted Laparoscopy in the Diagnosis and Management of Endometriosis.

Traditionally, surgeons had to diagnose endometriosis and determine themselves which lesions were painful, since the patients were anesthetized. Performing laparoscopy under local anesthesia allows the woman to assist the physician in deciding which lesions are painful and require therapy, and lets the patient determine the results of therapy. Patients reported that black lesions were not painful or were the least painful, followed by white scarred areas.

Patient-Assisted Laparoscopy.

With the development of better optics, laparoscopes of small diameter now give the surgeon the same view as large 10-mm laparoscopes. This in turn, allows laparoscopy to be performed with local rather than general anesthesia. Because the response to procedures done under local anesthesia varies from patient to patient depending on pain tolerance and anxiety, the approach must be flexible.