title: Surgical treatment affects perceived stress differently in women with endometriosis: correlation with severity of pain.
abstract: OBJECTIVE
  To investigate the amount of perceived stress in a group of women with different forms of endometriosis-related pain before and after surgical treatment.
  
  
  METHODS
  Prospective clinical trial.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  A group of women (n = 98) referred to our center for chronic pain and suspected of having endometriosis.
  
  
  METHODS
  All women suspected of having endometriosis with ultrasonography underwent to a clinical evaluation including assessment of perception of stress. Endometriosis was confirmed histologically by laparoscopy. Painful symptoms and perception of stress were recorded 1 month after surgery.
  
  
  METHODS
  Perceived stress scale (PSS) and visual analog scale for painful symptoms before and 1 month after surgery for endometriosis.
  
  
  RESULTS
  The PSS score before surgery was perceived as "very high" in patients with deep endometriosis (n = 20) or deep endometriosis associated with endometrioma (n = 21); "high" or "medium" PSS was perceived in patients with endometrioma (n = 34) or endometrioma associated with peritoneal endometriosis (n = 23). After the surgical treatment a significant decrease of the "very high" PSS score was shown, as well as when the entire group of patients was considered. When evaluated before and after surgery, according to the severity of pain (dysmenorrhea, dyspareunia, and pelvic pain), a direct correlation was found with the level of PSS.
  
  
  CONCLUSIONS
  Patients with deep endometriosis-related pain (dysmenorrhea, pelvic pain, dyspareunia) showed the highest level of perceived stress, which significantly decreased after surgical treatment.
authors.affiliation: Obstetrics and Gynecology, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Lazzeri
authors.affiliation: Obstetrics and Gynecology, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Vannuccini
authors.affiliation: Obstetrics and Gynecology, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: Cinzia
authors.initials: C
authors.lastname: Orlandini
authors.affiliation: Obstetrics and Gynecology, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Luisi
authors.affiliation: Obstetrics and Gynecology, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
authors.forename: Errico
authors.initials: E
authors.lastname: Zupi
authors.affiliation: Research Center for Reproductive Medicine, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, University of Pavia, Pavia, Italy.
authors.forename: Rossella Elena
authors.initials: RE
authors.lastname: Nappi
authors.affiliation: Obstetrics and Gynecology, Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy. Electronic address: felice.petraglia@unisi.it.
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery; D005260:Female; D006801:Humans; D010147:Pain Measurement / Q000379:methods / Q000523:psychology*; D058748:Pain Perception; D017699:Pelvic Pain / Q000175:diagnosis / Q000523:psychology* / Q000601:surgery; D011446:Prospective Studies; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000175:diagnosis / Q000523:psychology*; D016896:Treatment Outcome
keywords: Endometriosis; emotional well-being; pain; perceived stress; surgery