The influence of peritoneal endometriotic lesions on the generation of endometriosis-related pain and pain reduction after surgical excision

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This prospective study investigated how different endometriotic lesions, particularly peritoneal implants, influence pain and pain reduction after surgical excision in 44 patients.

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This prospective study investigated how different types of endometriotic lesions, especially peritoneal endometriotic implants, influence pain generation and the magnitude of pain reduction after surgical excision. Fifty-one pre-menopausal patients undergoing laparoscopy for chronic pelvic pain, dysmenorrhoea and/or ovarian cysts were assessed with standardized pre- and post-operative pain scores using a visual analogue scale, and patients with peritoneal endometriosis were stratified by baseline pain score. Patients with peritoneal endometriosis and higher baseline pain (group A) and patients with endometriosis without peritoneal implants (group C) had postoperative pain score decreases of at least two grades, whereas patients without endometriosis (group D) showed no significant reduction. The paper frames this finding with the caveat that reductions were not seen in the no-endometriosis group, limiting interpretation of pain outcomes beyond those with diagnosed disease. This paper is centrally about endometriosis — it specifically evaluates how peritoneal endometriotic lesions affect endometriosis-related pain and pain change after surgical excision.

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Abstract

PurposeTo investigate the influence of different kinds of endometriotic lesions, especially peritoneal endometriotic implants in pain generation and the pain reduction after surgical excision in a prospective study.MethodsFifty-one pre-menopausal patients underwent surgical laparoscopy due to chronic pelvic pain, dysmenorrhoea and/or for ovarian cysts. In 44 patients, endometriosis was diagnosed. The pre- and post-operative pain score was determined using a standardized questionnaire with a visual analogue scale. Patients with peritoneal endometriosis were divided into two different groups depending on their pre-operative pain score: group A had a pain score of 3 or more, while group B a pain score of 2 or less. Patients without peritoneal endometriosis were classified as group C, and patients without endometriosis were classified as group D. The pre- and post-operative pelvic pain and/or dysmenorrhoea was analysed according to the different types of endometriotic lesions.ResultsIn groups A and C, the post-operative pain score decreased by at least 2 grades or more (p < 0.0). In group D, the post-operative pain score showed no significant reduction.ConclusionThe present study suggests that the surgical excision of endometriotic lesions -- including peritoneal implants -- is an effective treatment of endometriosis-associated pelvic pain and/or dysmenorrhoea.
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Abstract

Purpose To investigate the influence of different kinds of endometriotic lesions, especially peritoneal endometriotic implants in pain generation and the pain reduction after surgical excision in a prospective study.

Methods

Fifty-one pre-menopausal patients underwent surgical laparoscopy due to chronic pelvic pain, dysmenorrhoea and/or for ovarian cysts. In 44 patients, endometriosis was diagnosed. The pre- and post-operative pain score was determined using a standardized questionnaire with a visual analogue scale. Patients with peritoneal endometriosis were divided into two different groups depending on their pre-operative pain score: group A had a pain score of 3 or more, while group B a pain score of 2 or less. Patients without peritoneal endometriosis were classified as group C, and patients without endometriosis were classified as group D. The pre- and post-operative pelvic pain and/or dysmenorrhoea was analysed according to the different types of endometriotic lesions.

Results

In groups A and C, the post-operative pain score decreased by at least 2 grades or more (p < 0.0). In group D, the post-operative pain score showed no significant reduction.

Conclusion

The present study suggests that the surgical excision of endometriotic lesions—including peritoneal implants—is an effective treatment of endometriosis-associated pelvic pain and/or dysmenorrhoea. Similar content being viewed by others

References

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Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Kaiser, A., Kopf, A., Gericke, C. et al. The influence of peritoneal endometriotic lesions on the generation of endometriosis-related pain and pain reduction after surgical excision. Arch Gynecol Obstet 280, 369–373 (2009). https://doi.org/10.1007/s00404-008-0921-z Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-008-0921-z

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Condition tags

dysmenorrheaendometriosischronic_pelvic_pain

MeSH descriptors

Dysmenorrhea Endometriosis Ovarian Cysts Pelvic Pain Adult Chronic Disease Dysmenorrhea Dysmenorrhea Endometriosis Endometriosis Female Humans Laparoscopy Middle Aged Ovarian Cysts Ovarian Cysts Pain Measurement Pelvic Pain Pelvic Pain Peritoneum

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