Relação entre dor e localização das lesões de endometriose: um estudo com foco em portadoras de endometriose profunda

Introduction: Endometriosis is the presence of endometrial tissue outside the uterine cavity that affects 10-15% of women on reproductive age. Deep infiltrating endometriosis penetrates more than 5 mm deep in the structure affected. The disease can infiltrate various organs, causing intense painful symptoms and therefore decrease the quality of life. The women with endometriosis may be asymptomatic in 2-50% of cases. Surgical treatment aims to improve the pain and quality of life (QOL), but 20% of women undergoing excision of lesions remain symptomatic. The objective of the study is therefore to investigate the relationship between pain and endometriotic lesions localization. Methods: We conducted a cross-sectional observational study in women of reproductive age in two services in the city of Rio de Janeiro, with laparoscopic diagnosis of deep infiltrating endometriosis, from June 2011 to April 2013. We excluded patients with any illness or trauma referred that can interfere with the perception of pain and quality of life. Were obtained data from the interview, the visual analoge scale, the Short Form 36 and the Endometriosis Health Profile 30 QoL questionnaires. The patients had anatomical sites mapped during surgery and subsequently grouped into anatomical compartments. Results: We evaluated 72 patients with a median age of 35 years. Most were nulliparous, with higher education, white race, with sexual partner and nonsmoker. The posterior was the most common anatomical compartment (72.2%) and dyspareunia was the most frequent symptom (79,2%). The intensity of dysmenorrhea was statistically significant compared to lesions in the anterior compartment of the uterus (P=.019), as well as menstrual disquezia compared to lesions in the rectosigmoid (P=.009) and parametrium (P=.017). The pain scale in QoL questionnaires, is not related to any compartment. Conclusions: Menstrual disquezia is related to the presence of lesion in the rectosigmoid and parametrium, as well as dysmenorrhea is associated with the absence of lesion in the anterior compartment of the uterus.