Relation between pain symptoms and the anatomic location of deep infiltrating endometriosis.
OBJECTIVE
To investigate whether specific types of pelvic pain are correlated with the anatomic locations of deeply infiltrating endometriosis (DIE).


METHODS
Retrospective data analysis.


METHODS
University tertiary referral center.


METHODS
Two hundred and twenty-five women with pelvic pain symptoms and DIE.


METHODS
During surgery, we recorded the anatomic locations of DIE implants and associated endometriosis.


METHODS
We studied the incidence of pelvic pain symptoms including severe dysmenorrhea, deep dyspareunia, noncyclic chronic pelvic pain, painful defecation during menstruation, urinary tract symptoms, and gastrointestinal symptoms as related to the location of DIE.


RESULTS
The frequency of severe dysmenorrhea increased with Douglas pouch adhesions and decreased with parity. The frequency of dyspareunia increased with a uterosacral ligament DIE location and decreased when it involved the bladder. The frequency of noncyclic chronic pelvic pain was higher when it involved the bowel and was lower for women who were treated for infertility. The frequency of painful defecation during menstruation was higher when DIE involved the vagina; lower urinary tract symptoms were more frequent when DIE involved the bladder and less frequent in women with a lower body mass index. Gastrointestinal symptoms were associated with bowel or vaginal DIE locations.


CONCLUSIONS
The types of pelvic pain are related to the anatomic location of DIE. Knowledge of the characteristics of pelvic pain symptoms is important in the preoperative assessment of patients with suspected DIE.
Fauconnier
Arnaud
A
Service de Chirurgie Gynécologique, Clinique Universitaire Baudelocque, CHU Cochin, Saint Vincent de Paul, La Roche-Guyon, Paris, France.
Chapron
Charles
C
Dubuisson
Jean-Bernard
JB
Vieira
Marco
M
Dousset
Bertrand
B
Bréart
Gérard
G
D000328:Adult; D015992:Body Mass Index; D003672:Defecation; D004064:Digestive System / Q000473:pathology; D004412:Dysmenorrhea / Q000453:epidemiology; D004414:Dyspareunia / Q000453:epidemiology; D004715:Endometriosis / Q000473:pathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008598:Menstruation; D017699:Pelvic Pain; D012189:Retrospective Studies; D001743:Urinary Bladder / Q000473:pathology; D014551:Urinary Tract / Q000473:pathology; D014599:Uterus / Q000473:pathology; D014621:Vagina / Q000473:pathology