Features of pain syndrome in women with different forms of endometriosis

В. Д. Воробій
In: HEALTH OF WOMAN · 2018 · pp. 87–89 · doi:10.15574/hw.2018.134.87 · W3174735903
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This study found that women with internal genital endometriosis experience more severe pain, including chronic pelvic pain and severe dysmenorrhea, dyspareunia, and dyschezia, compared to those with external genital endometriosis.

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This study evaluated the characteristics and severity of pain in 103 women diagnosed with either external or internal genital endometriosis compared to a control group. Using the Visual Analogue Scale, researchers found that chronic pelvic pain was significantly more common in patients with internal endometriosis than in those with external lesions. The data indicated that while both groups frequently experienced dysmenorrhea and dyspareunia, severe pain and non-cyclic pain were markedly more prevalent in the internal endometriosis cohort. This paper is centrally about endometriosis — specifically comparing pain syndrome features between external and internal forms of the disease.

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Abstract

The objective: to assess the type and intensity of pain in women with different endometriosis forms. Materials and methods. The research included 65 women with diagnosis of external genital endometriosis who formed I group. 38 patients with internal genital endometriosis consisted II group. Control group involved 30 persons of reproductive age without diagnosis of genital endometriosis. Visual Analogue Scale (VAS) was used to determine intensity of pain. Results. Chronic pelvic pain was more typical for patients in II group than in I (χ2=12.11; p<0.001). Also 69.23% women in I group and 86.84% in II suffered from dysmenorrhea, 43.08% and 42.11% respectively – from dyspaurenia, 10.77% and 15.79% – from dyschezia. 57.89% women in II group complained of pain which was not connected with menstrual cycle that was more often, than in I group (χ2=4.73; p=0.03). 10.77% patients with external genital endometriosis had no complaints against none women with internal endometriosis. According to VAS results mild (43.08%) and moderate (46.15%) pain was more often by external endometriosis. Only 10.77% of persons in I group indicated on severe pain. While, by internal endometriosis quantity of women with mild and moderate pain was less than by external one (28.95% and 36.84% respectively) and one third of individuals in this groups suffered from severe pain (34.21%; χ2=6.98; p=0.008). Conclusion. Pain syndrome is the typical clinical manifestation in women with endometriosis. Type of pain, its intensity is more severe by internal genital endometriosis than by external one. Key words: endometrios, pain, assessment.
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Materials

and methods. The research included 65 women with diagnosis of external genital endometriosis who formed I group. 38 patients with internal genital endometriosis consisted II group. Control group involved 30 persons of reproductive age without diagnosis of genital endometriosis. Visual Analogue Scale (VAS) was used to determine intensity of pain. Results. Chronic pelvic pain was more typical for patients in II group than in I (χ2=12.11; p<0.001). Also 69.23% women in I group and 86.84% in II suffered from dysmenorrhea, 43.08% and 42.11% respectively – from dyspaurenia, 10.77% and 15.79% – from dyschezia. 57.89% women in II group complained of pain which was not connected with menstrual cycle that was more often, than in I group (χ2=4.73; p=0.03). 10.77% patients with external genital endometriosis had no complaints against none women with internal endometriosis. According to VAS results mild (43.08%) and moderate (46.15%) pain was more often by external endometriosis. Only 10.77% of persons in I group indicated on severe pain. While, by internal endometriosis quantity of women with mild and moderate pain was less than by external one (28.95% and 36.84% respectively) and one third of individuals in this groups suffered from severe pain (34.21%; χ2=6.98; p=0.008). Conclusion. Pain syndrome is the typical clinical manifestation in women with endometriosis. Type of pain, its intensity is more severe by internal genital endometriosis than by external one. Key words: endometrios, pain, assessment.

References

1. Taktyka vedennia patsiientok z henitalnym endometriozom. Elektronnyi resurs: nakaz M-va okhorony zdorovia Ukrainy № 319 vid 06.04.2016 r. URL: http://moz.gov.ua/ua/portal/dn_20160406_0319.html. 2. Endometrioz: diagnostika, lechenie i reabilitatsiya: federalnyie klinicheskie rekomendatsii po vedeniyu bolnyih. (2013). M.:65. 3. Lövkvist L, Boström P, Edlund M, Olovsson M. (2016). Age-Related Differences in Quality of Life in Swedish Women with Endometriosis. J. Womens Health (Larchmt). 25;6:646–653. https://doi.org/10.1089/jwh.2015.5403. 4. Bylinka J, Oniszczenko W. (2016). Temperament, Beliefs About Pain Control, and Pain Intensity in Endometriosis Patients. J. Clin. Psychol. Med. Settings. 23;4:410–419. https://doi.org/10.1007/s10880-016-9473-8; PMid:27738846 PMCid:PMC5131087 5. Exacoustos C, Manganaro L, Zupi E. (2014). Imaging for the evaluation of endometriosis and adenomyosis. Best Pract. Res. Clin. Obstet. Gynaecol. 28;5:655–681. https://doi.org/10.1016/j.bpobgyn.2014.04.010. 6. Kim SA, Um MJ, Kim HK et al. (2016). Study of dienogest for dysmenorrhea and pelvic pain associated with endometriosis. Obstet. Gynecol. Sci. 59;6:506–511. https://doi.org/10.5468/ogs.2016.59.6.506; PMid:27896253 PMCid:PMC5120070 7. Bourdel N, Alves J, Pickering G et al. (2015). Systematic review of endometriosis pain assessment: how to choose a scale? Hum. Reprod. Update. 21;1:136–152. https://doi.org/10.1093/humupd/dmu046. 8. Wickström K, Edelstam G. (2017). Minimal clinically important difference for pain on the VAS scale and the relation to quality of life in women with endometriosis. Sex Reprod. Health 13:35–40. https://doi.org/10.1016/j.srhc.2017.05.004.

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VAS-pain

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endometriosischronic_pelvic_paindysmenorrhea

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