Τίτλος:
Endometriosis in patients with chronic pelvic pain: Is staging
predictive of the efficacy of laparoscopic surgery in pain relief?
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background/Aims: 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. Methods: 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. Results:
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%).
Conclusions: 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.
Συγγραφείς:
Milingos, Spyros
Protopapas, Athanasios
Kallipolitis, George and
Drakakis, Petros
Loutradis, Dimitrios
Liapi, Anthoula and
Antsaklis, Aris
Περιοδικό:
Gynecologic and Obstetric Investigation
Λέξεις-κλειδιά:
endometriosis; chronic pelvic pain; laparoscopic surgery; laparoscopy;
diagnosis
