Surgery for Chronic Pelvic Pain
Laparotomy is a surgical procedure that is done by making an
incision in the lower abdomen. This allows the surgeon to see and inspect the
abdominal cavity for structural problems, sites of
endometriosis (implants), and scar tissue (adhesions). The surgeon can then remove implants and
adhesions. The surgeon can also correct structural problems that interfere with
an organ's normal function, such as removing adhesions from the bowel
Many of the procedures that required a laparotomy in the
past can now be done with
laparoscopy, which uses a smaller incision. Ask your
surgeon why laparotomy is required.
What To Expect After Surgery
General anesthesia is usually
- The hospital stay varies from 2 to 4 days.
will likely be able to return to normal activities in 3 to 4 weeks.
Why It Is Done
Laparotomy is a likely treatment for moderate
chronic female pelvic pain when:
A laparotomy is usually required to remove:
- Sites of endometriosis (implants) and scar
tissue (adhesions) that:
- Bind one segment of bowel to another
segment or to other structures in the pelvis.
- Have penetrated
deeply into an abdominal organ and cannot be safely removed by
- Large sites of scar tissue
- Nerves, for pain control (presacral
How Well It Works
Surgery for chronic female pelvic
pain should be limited to the treatment of surgically correctable problems.
There is no evidence that surgical removal of the reproductive organs relieves
chronic pelvic pain.1
- Pain may not be controlled or may get
- Scar tissue (adhesions) may form at the surgical site, on
the ovaries or fallopian tubes, or in the pelvis.
What To Think About
Laparotomy may be needed when scar
tissue binds abdominal organs, impairing their function. But a laparotomy
may cause more scar tissue to form.
It is important that your
surgeon understands your treatment goals. Be sure you discuss your goals, such
as the desire for future pregnancies. If fertility is not your primary
treatment goal, a decision could be made to remove one or both ovaries, one or
both fallopian tubes, or the uterus during a laparotomy.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
Andrews J, et al. (2012). Noncyclic Chronic Pelvic Pain Therapies for Women. Comparative Effectiveness Review No. 41 (AHRQ Publication No. 11(12)-EHC088-1). Rockville, MD: Agency for Healthcare Research and Quality. Available online
Primary Medical Reviewer
||Sarah Marshall, MD - Family Medicine
Specialist Medical Reviewer
||Kirtly Jones, MD - Obstetrics and Gynecology
Current as of
||March 12, 2014