{"paper_id":"9e31afa9-089c-41d5-97cc-7f121e43670e","body_text":"Subscribe to RSS\nDOI: 10.1055/s-0044-1790156\nLesion size and location in deep infiltrating bowel endometriosis: correlation with gastrointestinal dysfunction and pain\nAuthors\nIntroduction: Deep infiltrating bowel endometriosis (DE) is associated with occurrence of dyschezia and gastrointestinal (GI) symptoms. The degree of the disease, the lesion length and the location, i.e. lesion-to-anal-verge distance (LAVD) of DE, as well as the severity of the symptoms appear to be correlated. The present study aims to evaluate a possible correlation of lesion location (LAVD) and size (according to the #Enzian classification) with preoperative symptoms.\nMaterial and methods: In this prospective study, patients with histologically confirmed DE undergoing modified limited nerve-vessel sparing rectal segmental bowel resection (NVSSR) or full thickness discoid resection (FTDR) were evaluated. Extent of endometriosis was defined according to the #Enzian classification intraoperatively. The primary outcome measure was the correlation between lesion size and location with the GI function impairment reflected by presurgical lower anterior resection syndrome (LARS) scores; the secondary outcome were differences in presurgical numeric rating scale (NRS) pain scores of dyschezia, dyspareunia and dysmenorrhea as well as the impact of concomitant DE of other locations on symptom intensity.\nResults: 151 patients were included in the final analysis. No significant correlation was observed between lesion size (#Enzian compartments C1/C2/C3) or LAVD and GI dysfunction reflected by LARS-like symptoms (p=0.314 and p=0.185, respectively) or pain symptoms (dyschezia, p=0.440; dyspareunia, p=0.136 and dysmenorrhea p=0.221). Furthermore, no significant correlation was observed between lesion size and GI dysfunction when merging two severity grades (#Enzian compartments C1 plus C2 versus C3) (p=0.611). In addition, LAVD did not affect the degree of dyschezia (p=0.892), dyspareunia (p=0.395) or dysmenorrhea (p=0.705). Finally, the presence of concomitant DE lesions infiltrating the vagina/rectovaginal space (#Enzian compartment A) and/or sacrouterine ligaments/ parametrium (#Enzian compartment B) did not alter the severity of preoperative dyschezia (p=0.493) or dysmenorrhea (p=0.128) but showed a trend towards affecting GI function (p=0.078) and was significantly associated with dyspareunia (p=0.035).\nConclusion: In present study we could not find a correlation between colorectal DE lesion size and location (LAVD) and GI function impairment or pain symptoms intensity. Involvement of #Enzian compartment A and/or B exerts a significant impact on the degree of dyspareunia in women with colorectal DE.\nPublication History\nArticle published online:\n02 September 2024\n© 2024. Thieme. All rights reserved.\nGeorg Thieme Verlag KG\nRüdigerstraße 14, 70469 Stuttgart, Germany","source_license":"CC0","license_restricted":false}