Pijnsymptomen als predictor van endometriose na negatieve transvaginale echografie

A. Stockmans, Arne Vanhie
In: Tijdschrift voor Geneeskunde · 2024 · doi:10.47671/tvg.80.24.106 · W4404596301
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Symptomatic women with negative ultrasound scans had a high prevalence of endometriosis, which was more refractory to hormonal treatment and associated with higher pain medication use.

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Abstract

This is a monocentric retrospective study at a tertiary center for endometriosis. The primary objective of this study is to measure the prevalence of endometriosis in symptomatic but imaging negative patients undergoing diagnostic laparoscopy. The secondary aim is to determine whether differences in pain symptoms are observed between patients in whom endometriosis is found and patients with a negative laparoscopy. Patients who underwent diagnostic laparoscopy for endometriosis between 01/01/2018 and 31/12/2022, after negative imaging, were included. All parameters from the pain section in the WERF-EPHect EPQ-S/M were compared between patients with and without endometriosis. 89 patients met the inclusion criteria. The prevalence of endometriosis is high (74.2%) in symptomatic imaging negative patients. In the majority of cases, minimal (66.7%) or mild endometriosis (28.8%) was found in patients and in 3 (4.5%) cases moderate endometriosis was found. Comparison of pain symptoms between patients with and without endometriosis was similar for pain scores in dysmenorrhea, dyspareunia and chronic pelvic pain. However, women diagnosed with endometriosis were less likely to benefit from taking hormones to reduce dysmenorrhea (p=0.040; OR 0.25) and were more likely to have stopped taking hormones or changed hormones due to inadequate pain control (p=0.022; OR 3.85). In addition, patients with endometriosis had a higher intake of pain medication in the past three months to help relieve general pelvic pain (p=0.04; OR 3.53). Thus, our data suggest a pain phenotype that is more refractory to hormonal treatment in patients with endometriosis.

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Condition tags

endometriosischronic_pelvic_paindysmenorrheadyspareunia

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