Endometriosis in patients with chronic pelvic pain: is staging predictive of the efficacy of laparoscopic surgery in pain relief?

Endometriosis is considered an important cause of chronic pelvic pain. Despite its high prevalence, controversy still exists regarding the true association between the extent of endometriosis and the severity of symptoms. We conducted this prospective study to investigate the association between the stage of endometriosis and type and severity of pain, and to evaluate the efficacy of laparoscopic surgery in pain relief. Ninety-five patients complaining of chronic pain were diagnosed with endometriosis and were treated with laparoscopic surgery. The severity of pain was assessed in patients with an endometriosis AFS (American Fertility Society) score less than 16 (group 1) and those with an AFS score greater than or equal to 16 (group 2), preoperatively and 6 months after surgery, using a visual pain scale. Any reduction in pain scores by 2 points or more was considered to be an improvement. Dysmenorrhea and deep dyspareunia, were significantly more frequent in patients of group 2. Preoperative pain scores were significantly higher for dysmenorrhea (p = 0.0022) and deep dyspareunia (p < 0.0001) but not for non-menstrual pain in group 2. Deep dyspareunia was correlated with the presence of dense pelvic adhesions. After surgery, dysmenorrhea improved in 43% of cases in group 1, vs. 66% of cases in group 2 (p = 0.0037). For deep dyspareunia, improvement was reported by 33% in group 1, vs. 67% in group 2 (p = 0.074). Improvement in non-menstrual pain was not significantly different between the two groups (67% vs. 56%). Advanced endometriosis is more frequently related to dysmenorrhea and deep dypareunia in comparison to early disease. Laparoscopic surgery may offer relief or improvement in the majority of patients with endometriosis and chronic pelvic pain. Cases with advanced disease seem to benefit the most.

Milingos S ，Protopapas A ，Kallipolitis G ，Drakakis P ，Loutradis D ，Liapi A ，Antsaklis A ... -  《GYNECOLOGIC AND OBSTETRIC INVESTIGATION》

Correlation between endometriosis and pelvic pain.

Porpora MG ，Koninckx PR ，Piazze J ，Natili M ，Colagrande S ，Cosmi EV ... -  《-》

[Relationship between pain symptoms and clinico-pathological features of pelvic endometriosis].

Leng JH ，Lang JH ，Dai Y ，Li HJ ，Li XY ... -  《-》

[Correlation between pelvic adhesions and pain symptoms of endometriosis].

Hao M ，Zhao WH ，Wang YH 《-》

[Are there anatomical and clinical correlations between minimal and deep endometriosis? First results of Auvergne's Registry of Endometriosis].

Chêne G ，Jaffeux P ，Lasnier C ，Aublet-Cuvelier B ，Matsuzaki S ，Jardon K ，Mage G ，Pouly JL ，Canis M ... -  《GYNECOLOGIE OBSTETRIQUE & FERTILITE》