Relating pelvic pain location to surgical findings of endometriosis.
Relating pelvic pain location to surgical findings of endometriosis.
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DOI：
10.1097/aog.0b013e318223fed0
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发表时间：
2011-08
影响因子：
7.2
通讯作者：
Stratton P
中科院分区：
文献类型：
--
作者：
Hsu AL;Sinaii N;Segars J;Nieman LK;Stratton P
目的：研究慢性盆腔疼痛和子宫内膜异位症患者的疼痛部位是否与病变部位有关。进行二次分析，将自我报告的疼痛部位与记录的腹腔镜检查结果进行比较，以确定所有可见病变的位置和特征。所有病变均被切除。子宫内膜异位症的诊断采用组织病理学标准。骨盆区分为三个前区和两个后区。确定每个区域的病变深度、病变或子宫内膜异位症的数量，以及疾病负担(定义为病变大小之和，或单个病变与多个病变之和)。使用t检验、Fisher精确检验和Logistic回归模型对数据进行分析，并使用逐步递减Bonferroni方法对多次比较的p值进行校正。与非子宫内膜异位症的慢性疼痛患者(n=37)相比，有子宫内膜异位症的妇女(n=96)的体重指数(BMI)更低，更可能是白人，有更多的手术经历，更频繁地出现月经疼痛和丧失工作能力。总体而言，很少有患者有深度浸润性病变(n=38)。排尿困难与浅表膀胱腹膜病变有关。其他病变或子宫内膜瘤与同一解剖位置的疼痛无关。病变深度、疾病负担、病变或子宫内膜异位症的数量与疼痛无关。在这组经活检证实为子宫内膜异位症的妇女中，很少有深度浸润性病变或子宫内膜异位症。排尿困难和中线前部疼痛是唯一与浅表子宫内膜异位症病变部位相关的症状。疼痛和浅表病变位置之间缺乏联系，这就提出了这些病变如何与疼痛相关的问题。ClinicalTrials.gov，www.Clinicaltrials.gov，NCT00001848。
To study whether pain location is related to lesion location in women with chronic pelvic pain and biopsy-proven endometriosis. A secondary analysis was performed to compare self-reported pain location with recorded laparoscopy findings for location and characteristics of all visible lesions. All lesions were excised. Endometriosis was diagnosed using histopathology criteria. The pelvic area was divided into three anterior and two posterior regions. Lesion depth, number of lesions or endometriomas, and disease burden (defined as sum of lesion sizes, or single versus multiple lesions) were determined for each region. Data were analyzed using t-tests, Fisher’s exact tests, and logistic regression modeling, with p-values corrected for multiple comparisons using the step-down Bonferroni method. Women with endometriosis (n=96) had a lower body mass index (BMI), were more likely to be white, had more prior surgery, and had more frequent menstrual pain and incapacitation than chronic pain patients without endometriosis (n=37). Overall, few patients had deeply infiltrating lesions (n=38). Dysuria was associated with superficial bladder peritoneal lesions. Other lesions or endometriomas were not associated with pain in the same anatomic locations. Lesion depth, disease burden, and number of lesions or endometriomas were not associated with pain. In this group of women with biopsy-proven endometriosis, few had deeply infiltrating lesions or endometriomas. Dysuria and midline anterior pain were the only symptoms associated with the location of superficial endometriosis lesions. The lack of relationship between pain and superficial lesion location raises questions about how these lesions relate to pain. ClinicalTrials.gov, www.clinicaltrials.gov, NCT00001848.