Appendectomy in patients undergoing laparoscopic surgery for pelvic pain

Area of Science:

• Gynecologic surgery
• Pathology
• Surgical oncology

Background:

• Pelvic pain is a common gynecologic complaint.
• Laparoscopic surgery is frequently used for diagnosis and treatment.
• Appendix pathology in this context is often overlooked.

Purpose of the Study:

• To evaluate the pathologic findings in the appendixes of women undergoing laparoscopic surgery for pelvic pain.
• To determine the incidence of various appendiceal pathologies in this patient group.

Main Methods:

• Retrospective study design (Canadian Task Force classification II-2).
• Analysis of 190 women undergoing prophylactic appendectomy during laparoscopic surgery for pelvic pain.
• Pathologic examination of removed appendix specimens.

Main Results:

• 154 out of 190 appendixes (81%) showed abnormal findings upon pathologic evaluation.
• Common findings included endometriosis, carcinoid tumors, chronic appendicitis, periappendicitis, fibrous obliteration, and lymphoid hyperplasia.
• Endometriosis was a notable finding in the appendix of women with pelvic pain.

Conclusions:

• A high frequency of abnormal pathologic findings exists in the appendixes of women undergoing laparoscopic surgery for pelvic pain.
• Patients should be counseled regarding these potential findings, particularly endometriosis.
• Prophylactic appendectomy is a worthwhile consideration in women undergoing surgery for pelvic pain due to the high rate of incidental appendiceal pathology.