Analysis of pain manifestations in extragenital endometriosis stage I-IV

Aim. To conduct a comparative analysis of pain manifestations in patients with extragenital endometriosis (EGE) stage I-IV with an emphasis on dysmenorrhea, dyspareunia, and chronic pelvic pain. Material and methods. Nineteen two patients who underwent surgery for EGE were divided into three representative age groups based on the EGE stage, according to the Revised American Society for Reproductive Medicine classification of endometriosis. Group 1 included 12 (13%) patients with stage I EGE, group 2 consisted of 60 (65%) patients with stage II EGE, and group 3 comprised 20 (22%) patients with stage III EGE. The control group included 90 patients of a similar age who had laparoscopy before undergoing assisted reproductive technologies (ART). For statistical analysis, nonparametric statistics were used. Results. Chronic pelvic pain (CPP) is one of the leading manifestations of pain in EGE II and III stages. The relationship between visual analog scale (VAS) pain scores and the location and extent of endometriotic lesions was episodic. A relationship was found between dyspareunia and endometriosis of pelvic peritoneum and uterosacral ligaments, and between CPP andfocal lesions in the bladder peritoneum, ovaries, and retrocervical endometriosis. Conclusion. Types of EGE-related pain and their combinations were not associated with specific stages of the disease. The presence and intensity of dyspareunia is a strong sign of the presence and extent of endometriosis of the pelvic peritoneum and uterosacral ligaments. This relationship is predictive and may help develop a diagnostic strategy and guide pre-surgical planning.

extragenital endometriosis, statistical analysis, pain, dysmenorrhea, dyspareunia, chronic pelvic pain