Clinical analysis of 29 cases of misdiagnosed endometriosis

Objective To investigate the clinical methods of differential diagnosis between pelvic inflammatory disease (PID) and endometriosis (EM).Methods The clinical data of 29 cases of PID who were misdiagnosed as EM and 72 cases of EM were analyzed retrospectively.Results The sensitivity for symptoms such as non-secondum dysmenorrhea,non-dyspareunia,non-tenderness nodules at uterosacral ligament,chronic pelvic pain and menarche age older than 14 years to diagnose PID were 72.4%,96.6%,86.2%,65.5% and 69.0%,respectively,and the specificity for that were 58.3%,20.8%,59.7%,62.5% and 54.2%. Among the factor-combinations,the ones having higher sensitivity were non-secondum dysmenorrhea or non-dyspareunia,non-dyspareunia or non-tenderness nodules at uterosacral ligament,chronic pelvic pain or non-dyspareunia,menarche age older than 14 years or non-dyspareunia,chronic pelvic pain or non-tenderness nodules at uterosacral ligament,with the sensitivity of 100%,100%,96.6%,96.6% and 96.3%,respectively;the ones having higher specificity were chronic pelvic pain and non-tenderness nodules at uterosacral ligament,chronic pelvic pain and non-secondum dysmenorrhea,chronic pelvic pain and menarche age older than 14 years,with the specificity of 88.9%、86.1%、83.3%,respectively. From the multivariate analysis,three factors entered the final formula,they were menarche age,tenderness nodules at uterosacral ligament and chronic pelvic pain. The formula for the potentiality of EM was: 1/[1+e-(5.591-1.75×chronic pelvic pain yes/no-0.355× menarche age +2.482× tenderness nodules at uterosacral ligament yes/no)].With the cut value of 0.5,the accuracy of this formula was 82.3%.Conclusions Correct clinical examination will reduce the misdiagnosis rate of endometriosis.