The Association between Endometriosis Appearance during Laparoscopic Surgery and Pain Characteristic in Pelvic Endometriosis

Abstract

Objective : To evaluate the correlation between the American Society of Reproductive Medicine (ASRM) score in endometriosis and severity pelvic pain in a group of women with endometriosis. Methods : A total of 131 patients with pelvic pain who: conduct laparoscopy for diagnosis and therapy of endometriosis, have pain symptoms>3 months, and absence of pelvic anomalies. Dysmenorrhea, deep dyspareunia, dyschezia, dysuria, and chronic pelvic pain were evaluated using a 10-point visual analogue scale. The data was collected by assessing the medical record, and retrospective analysis was performed. Disease stage according to the American Society of Reproductive Medicine, the presence of adhesion, lesion type (Deep Infiltrating Endometriosis (DIE) or without DIE), and severity of pain symptoms were analysed by Spearman analysis. Different VAS between DIE vs non DIE group was analysed by Mann-Whitney analysis. Results : Stage IV endometriosis accounts for 79.4%. Based on the macroscopic appearance, ovarian endometriosis accounts for 92.4%, peritoneal endometriosis 82.4%, DIE was 40.5%, and adenomyosis was 19.1%. There was significant correlation between total ASRM, ovarian endometriosis, peritoneal lesion, Douglas pouch obliteration, adnexal adhesion score and VAS dysmenorrhea (r=0.303; 0.187; 0.203; 0.278; 0.266, p<0.05). There was significant VAS difference of DIE vs non DIE group; the difference was on dyspareunia (5.18±2.4 and 4.58±1.0, p<0.001] and dyschezia [5.28±2.2 and 4.86±0.7,p<0.001] Conclusions : There was a positive correlation between ovarian endometriosis score and severity of dysmenorrhea. There was also a difference in the degree of endometriosisassociated pain between DIE and non DIE group.