[Organic changes and pain after laparoscopic tubal sterilization]

In 100 women who underwent laparoscopic sterilization approximately one year before a follow-up check including gynecological examination, a structurized interview and a "Maudsley Personality Inventory" (MPI) test were performed. 6% complained about algopareunia before the operation which did not disappear afterwards. In 8 patients algopareunia started after the operation, only 2 of them presenting pelvic adhesions at control, whereas 6 patients suffered from psychogenic algopareunia. Neurotic tendency was evidently elevated in all those patients complaining about pelvic pain before and after operation. 6 patients had pelvipathia nervosa, 14 showed organic alterations, but these were not necessarily the reason for the complaints. Laparoscopy revealed pathologic processes e.g. adhesions, pelvic varicosis or adnexitis in 27%, but not more than 11% of these patients with obvious pathology had subjective complaints. These findings underline the fact that pathologic alterations will not necessarily explain pelvic pains and that in most cases psychosomatic factors must be taken into consideration.