Can specific pain symptoms help in the diagnosis of endometriosis? A cohort study of women with chronic pelvic pain

Objective: To investigate whether different dimensions of chronic pelvic pain are useful in the diagnosis of endometriosis. Design: A prospective questionnaire-based study of 185 women. Setting: Southeast of England. Patient(s): Women undergoing a diagnostic laparoscopy for chronic pelvic pain. Intervention(s): Preoperative questionnaire. Main Outcome Measure(s): Descriptions of pain, areas of pain, and pain intensity. Result(s): One hundred thirteen women (61%) had histologically confirmed endometriosis. Three pain descriptors were reported more commonly by women with endometriosis: throbbing, gnawing, and dragging pain to the legs. Compared with women with superficial endometriosis, those with deep disease were more likely to report shooting rectal pain and a sense of their insides being pulled down. Individual pain areas were unrelated to the surgical diagnosis. Area of pain was unrelated to area of endometriosis. Pain intensity was unrelated to the surgical diagnosis. Dyschezia was more severe in women with endometriosis. Conclusion(s): Women with endometriosis are more likely to report their pain as throbbing and experience dyschezia when compared with women with an apparently normal pelvis. These dimensions of pain may usefully contribute to the diagnostic picture. (Fertil Steril (R) 2010;94:20-7. (C) 2010 by American Society for Reproductive Medicine.)