The Place Of Appendectomy in Women with Chronic Pelvic Pain and Pelvic Endometriosis

Objectives: The purpose of this review was to evaluate the role of appendectomy in patients with pelvic pain and endometriosis. Design: This was a systematic review. Methods: A literature search in MEDLINE,(R) EMBASE, and the Cochrane Database of Systematic Reviews was performed, using the key words appendiceal endometriosis, pelvic pain, endometriosis, and appendectomy. Results: The prevalence of appendiceal endometriosis in women with endometriosis ranges between 9.5% and 44.3%. Removal of the appendix is associated with complete pain relief in these patients. Conclusions: Removal of a grossly abnormal appendix is associated with pain relief in approximately 90% of cases. Accordingly, women with chronic pelvic pain should be counseled appropriately before surgery, and the surgeon should perform a thorough examination of the appendix during laparoscopy. If the appendix looks abnormal, laparoscopic appendectomy is warranted.