A randomised trial of photograpic reinforcement during postoperative counselling after diagnostic laparoscopy for pelvic pain

OBJECTIVE: To measure the effect of seeing a photograph of the pelvic findings at laparoscopy. SETTING: Two university teaching hospitals. METHOD: A randomised-controlled trial. SUBJECTS: Two hundred thirty-three women undergoing diagnostic laparoscopy for the investigation of chronic pelvic pain. INTERVENTIONS: At operation a Polaroid print was taken of the pelvis. If this was of satisfactory quality, the patient was randomly allocated to either see, or not see, the print during the postoperative consultation. MAIN OUTCOMES: Pain severity and pain belief scores at 3 and 6 months. ANALYSIS: By intention to treat. RESULTS: Postoperative consultations with photographs did not improve immediate understanding and satisfaction with the consultation. In addition, compared to controls, both patients and doctors did not perceive particular benefit for communication from the photograph. There was a consistent trend to more pain in the photographic reinforcement group and more negative pain beliefs. At 3 months, the average within person differences showed some benefit in visual analogue pain scores, McGill affect scores, 'permanence' and 'self-blame' scores. These benefits were not statistically significant. At 6 months, there was a consistent pattern of benefit from pain severity and pain beliefs, again these benefits were not statistically significant. CONCLUSION: No clear benefits result from showing patients photographs of their pelvis.