Peritoneal endometriosis. Morphologic appearance in women with chronic pelvic pain.
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This study evaluated 73 women with endometriosis and chronic pelvic pain, finding a significant association between deep dyspareunia and both typical/mixed lesions and typical/atypical lesions.
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Abstract
A prospective study analyzed the prevalence and severity of dysmenorrhea, intermenstrual pain and deep dyspareunia in relation to morphologic features of peritoneal disease in 73 consecutive women with endometriosis but no associated pelvic pathology, previous pelvic surgery or hormonal treatment. All underwent their first laparoscopy for chronic pelvic pain at the First Department of Obstetrics and Gynecology, University of Milan, Milan, Italy, between 1986 and 1989. Gynecologic pain symptoms were evaluated with a verbal score and visual analog scale. Peritoneal lesions were classified as typical (black nodules, yellow-brown patches, stellate scars), atypical (clear vesicles, clear or red papules, red polypoid lesions) or mixed. When the three types of lesions were considered together, a statistically significant association was observed only with deep dyspareunia (P less than .01). Moreover, a significantly higher prevalence of deep dyspareunia was revealed in patients with typical versus atypical lesions (P less than .01) and in those with mixed versus atypical lesions (P less than .05). Fresh, papular, atypical lesions exposed to peritoneal fluid might cause functional pain, whereas "old," black nodules immersed in infiltrating scars might provoke mainly organic pain.
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- Priorities for Endometriosis Research: A Proposed Focus on Deep Dyspareunia 2010
- The influence of peritoneal endometriotic lesions on the generation of endometriosis-related pain and pain reduction after surgical excision 2009
- Medical, surgical and alternative treatments for chronic pelvic pain in women: a descriptive review 2009
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- A pilot study to evaluate the clinical relevance of endometriosis-associated nerve fibers in peritoneal endometriotic lesions 2008
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- Association between endometriosis stage, lesion type, patient characteristics and severity of pelvic pain symptoms: a multivariate analysis of over 1000 patients 2007
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- "Endometriose do trato gastrointestinal: correlações clínicas e laparoscópicas; papel da corrida dos órgãos peritoneais na endometriose (COPE)" 2005
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- 10.1016/s0246-1064(19)30028-3 2000
- Correlation between endometriosis and pelvic pain 1999
- Combined Medical and Surgical Treatment of Women with Endometriosis 1999
- An Update on the Classification of Endometriosis 1999
- Endometriosis and Pelvic Pain 1998
- Verhaltensmedizin bei Frauen mit chronischen Unterbauchbeschwerden 1998
- of pelvic pain in women 1997
- Prediction of pregnancy in infertile women based on the American Society for Reproductive Medicine's revised classification of endometriosis 1997
- CLASSIFICATION OF ENDOMETRIOSIS 1997
- Correlation between endometriosis-associated dysmenorrhea and the presence of typical or atypical lesions 1997
- PATHOPHYSIOLOGY 1997
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