Evaluation of the Impact of Endometriotic Lesions on Patient'S Pelvic Pain Symptoms

Carlo Saccardi, A. Borghero, Erich Cosmi, Lorena Conte, Donatella Caserta, Pietro Litta
In: Journal of Endometriosis · 2010 · vol. 2(3) , pp. 155–163 · doi:10.1177/228402651000200307 · W4248101795
article OA: closed CC0 ⤵ 3 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This study analyzed data from 537 women with endometriosis and found a strong association between rectovaginal endometriotic nodules and deep dyspareunia, but no precise relationship between specific pain symptoms and lesion characteristics.

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Abstract

Purpose To verify if different endometrial lesions determine the diagnostic symptom panel for a specific symptom. Methods We recruited 537 women with endometriosis who underwent laparoscopic surgery. Data on patient characteristics, severity of pelvic pain symptoms, disease stage and anatomical characteristics of endometriotic lesions were collected and analyzed by univariate analysis, followed by multiple logistic regression. Results We observed a strong inverse relationship between pain symptoms and, respectively, the age of women at surgery (OR 0.885; p<0.05) and nulliparity (OR 5.6; p<0.05). A significant association between dysmenorrhea and nulliparity (OR 10.1; p< 0.01) and dysmenorrhea and rAFS stage (OR 4.7; p<0.05) was also confirmed. Finally a strong relationship was found between the presence of a rectovaginal endometriotic nodule and pain symptoms: dyspareunia (OR 13.8, p<0.001) and dysmenorrhea (OR 2.3, p<0.05). Significant relationships were found between the presence of peri-annexial adherences and, respectively, bilateral endometrioma (p<0.01) and size of endometrioma (p<0.05); between the presence of pelvic adherential syndrome and, respectively, bilateral ovarian cyst (p<0.01), size of ovarian cyst (p<0.01) and rectovaginal nodule (p<0.01). A strong relationship was found also between a rectovaginal nodule and the presence of entero-uterine adherences (p<0.01) and Douglas obliteration (p<0.01). Conclusions: It was not possible determine a precise relationship between a specific pain symptom and the anatomic-surgical characteristics of endometriotic lesions, even though a strong association was seen between a rectovaginal endometriotic nodule and deep dyspareunia. Typical clinical features of endometriosis are probably determined by the association of different characteristics of lesions and different pathogenic mechanisms.

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Condition tags

endometriosisendometriomadysmenorrheadyspareunia

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