Association between disease extent and pain symptoms in patients with deep infiltrating endometriosis

Eliana Montanari, Montanari E, Bernhard Dauser, Dauser B, J. Keckstein, Joerg Keckstein, Elisabeth Kirchner, Kirchner E, Nemeth Z, Zoltán H. Németh, Zoltan Nemeth, Hudelist G, Gernot Hudelist
Reproductive BioMedicine Online · 2019 · vol. 39(5) , pp. 845–851 · doi:10.1016/j.rbmo.2019.06.006 · PMID:31378689 · W2953047476
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This study investigated the relationship between the extent of disease and pain symptoms experienced by patients diagnosed with deep infiltrating endometriosis.

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Abstract

Research questionThe study aimed to assess the associations between pre-operative symptoms in patients with deep infiltrating endometriosis (DIE) and intraoperatively determined extent of disease as described by the revised ENZIAN score.DesignThis was a retrospective data analysis of women who underwent surgery for DIE between 2014 and 2018 at the Department of Gynecology, Hospital St. John of God, Vienna (a tertiary referral centre for endometriosis).ResultsData from 245 women were analysed. Statistically significant associations were found between involvement of ENZIAN compartment B (uterosacral ligaments, parametrium) and presence of dyspareunia (P = 0.002), ENZIAN compartment C (rectum, sigmoid colon) and dyschezia (P < 0.001), and ENZIAN compartment FB (urinary bladder) and dysuria (P < 0.001, Fisher's exact test). Statistically significant correlations were also detected between symptom severity of dyschezia and lesion size in ENZIAN compartment C (rs = 0.334, P < 0.001), and severity of dyspareunia and lesion size in ENZIAN compartment B (rs = 0.127, P = 0.046). Severity of dysmenorrhoea was correlated with lesion size in ENZIAN compartment A (rs = 0.244, P < 0.001) and was associated with the presence of adenomyosis (compartment FA; P = 0.005, Mann-Whitney U-test). Additionally, the number of affected compartments (A, B, C and FA) correlated with the severity of dysmenorrhoea (rs = 0.256, P < 0.001) and dyschezia (rs = 0.161, P = 0.012).ConclusionIn contrast to previous studies evaluating disease extent based on the revised American Society for Reproductive Medicine (rASRM) score, disease localization and extent as described by the revised ENZIAN score was associated and correlated with the presence and severity of different pre-operative symptoms. These explorative findings suggest that it may be important to evaluate the extent of DIE using the revised ENZIAN score in addition to the rASRM score.

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Condition tags

endometriosischronic_pelvic_paindie_deep_infiltrating

MeSH descriptors

Endometriosis Pelvic Pain Symptom Assessment Adult Databases, Factual Endometriosis Endometriosis Female Humans Observer Variation Pain Measurement Pelvic Pain Preoperative Period Retrospective Studies Severity of Illness Index Symptom Assessment Treatment Outcome

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References (18)

Cited by (50)

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