The evil twins of chronic pelvic pain syndrome: endometriosis and interstitial cystitis.

Maurice K Chung, Rosemary R Chung, David Gordon, C. E. Jennings, Charles Jennings
JSLS : Journal of the Society of Laparoendoscopic Surgeons · 2003 · vol. 6(4) , pp. 311–4 · PMID:12500828 · W192077823
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This retrospective review of 60 women found a high prevalence of both endometriosis and interstitial cystitis, indicating concurrent laparoscopic and cystoscopic evaluations are necessary for early diagnosis of these "evil twins" of chronic pelvic pain.

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Abstract

OBJECTIVE: To determine the value in the initial laparoscopic and cystoscopic evaluation of avoiding the unnecessary delay in diagnosing the "evil twins" of chronic pelvic pain syndrome, endometriosis and interstitial cystitis. METHODS: We performed a retrospective review of 60 women ranging in age from 19 to 62. They underwent concurrent laparoscopy, cystoscopy, and hydrodistentions from January 1999 to October 2000. A gynecology and urology team performed these procedures in these 60 patients at a regional pelvic pain center in Northwest Ohio. RESULTS: Fifty-eight patients (96.6%) were diagnosed with interstitial cystitis by the presence of glomerulation and terminal hematuria according to National Institutes of Health criteria. A diagnosis of (active and inactive) endometriosis was found in 56 patients (93.3%). Biopsy-confirmed active endometriosis was found in 48 patients (80%). In the interstitial cystitis patient group (58), 54 patients had a diagnosis of (active and inactive) endometriosis (93.1%), and 47 patients had biopsy-confirmed active endometriosis (81%). In the group of 56 patients with a diagnosis of (active and inactive) endometriosis, 54 patients were found to have interstitial cystitis (96.4%). In the group of 48 patients with active biopsy-confirmed endometriosis, 47 have interstitial cystitis (97.7%). CONCLUSION: Patients with chronic pelvic pain syndrome are very difficult to manage. Eighty percent were found to have endometriosis and had numerous previous operations. Many patients failed to respond to multiple therapies. In many cases, pain persists even after a hysterectomy. Through our study, we showed the high prevalence and association of interstitial cystitis and endometriosis, the evil twins of chronic pelvic pain syndrome. It is absolutely necessary to perform both laparoscopic and cystoscopic examinations concurrently with the patient anesthetized in the initial evaluation and treatment of chronic pelvic pain syndrome to avoid unnecessary delay in making the diagnosis of the evil twins, because chronic pelvic pain syndrome can be caused by either or both of these entities. It is very important to have the gynecologists and urologists working as a team in making an early diagnosis to resolve these chronic debilitating diseases.

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Condition tags

mesh:D004715mesh:D017699endometriosischronic_pelvic_paininterstitial_cystitis

MeSH descriptors

Cystitis, Interstitial Endometriosis Pelvic Pain Adult Chronic Disease Cystitis, Interstitial Cystitis, Interstitial Cystitis, Interstitial Cystoscopy Endometriosis Endometriosis Endometriosis Female Humans Laparoscopy Middle Aged Pelvic Pain

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (15)

Cited by (35)

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