Relation between pain symptoms and the anatomic location of deep infiltrating endometriosis
Open accessAbstract
Objective To investigate whether specific types of pelvic pain are correlated with the anatomic locations of deeply infiltrating endometriosis (DIE). Design Retrospective data analysis. Setting University tertiary referral center. Patient(s) Two hundred and twenty-five women with pelvic pain symptoms and DIE. Intervention(s) During surgery, we recorded the anatomic locations of DIE implants and associated endometriosis. Main outcome measure(s) 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. Result(s) 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. Conclusion(s) 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.
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Non-menstrual chronic pelvic pain and gastrointestinal symptoms are more common in women with bowel deeply infiltrating endometriosis, and painful defecation during menses is more common when DIE involves the vagina.
“Non-menstrual CPP and gastrointestinal symptoms occur at a higher rate in those with bowel DIE lesions and painful defecation during menses with DIE involving the vagina”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Fauconnier et al., 2002
The incomplete assessment strategy used in most endometriosis studies hampers assessment of pain outcomes and fails to consider diagnostic subtypes of chronic pelvic pain.
“This incomplete assessment strategy hampers assessment of pain outcomes (Vincent et al., 2008) and fails to consider diagnostic subtypes of CPP (Leserman et al., 2006), such as those noted with different locations of DIE (Fauconnier et al., 2002).”
From Chronic pelvic pain and endometriosis: translational evidence of the relationship and implications (2011) · cites this paper as Fauconnier et al., 2002
Women with endometriosis experience bowel and urinary symptoms that are also associated with the menstrual phase.
“Women with endometriosis experience bowel and urinary symptoms that are also associated with the menstrual phase (59, 60)”
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Thubert, T., Santulli, P., Marcellin, L., Menard, S., M'Baye, M., Streuli, I., Borghese, B., de Ziegler, D., & Chapron, C. (2014) · American Journal of Obstetrics and Gynecology · doi:10.1016/j.ajog.2014.01.022 · Cited by 18 · see citing works
Self-citationBourdon, M., Santulli, P., de Ziegler, D., Gayet, V., Maignien, C., Marcellin, L., & Chapron, C. (2017) · Reproductive Sciences · doi:10.1177/1933719116687659 · Cited by 15 · see citing works
Self-citationSETÄLÄ, M., SAVOLAINEN, H., KÖSSI, J., RANTA, T., & MÄKINEN, J. (2011) · Acta Obstetricia et Gynecologica Scandinavica · doi:10.1111/j.1600-0412.2011.01097.x · Cited by 11 · see citing works
Association Rate between Incisional and Pelvic Endometriosis
Alborzi, S., Hamedi, B., Abbasi, S., Parsanejad, M. E., & Zolghadri, J. (2011) · Journal of Endometriosis · doi:10.5301/je.2012.9087 · Cited by 2 · see citing works
- Authors
- Fauconnier, A., Chapron, C., Dubuisson, J.-B., Vieira, M., Dousset, B., & Bréart, G.
- Affiliations
- Inserm (FR)
- Hôpital Cochin (FR)
- Corresponding author
- Chapron, Charles
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2002-10
- Volume
- 78
- Issue
- 4
- Pages
- 719-726
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W1983956572
- Cited by
- 498
- References
- 45
- Citations by year
- 2026: 8 · 2025: 22 · 2024: 22 · 2023: 19 · 2022: 22 · 2021: 20 · 2020: 31 · 2019: 16 · 2018: 20 · 2017: 17 · 2016: 22 · 2015: 38 · 2014: 33 · 2013: 26 · 2012: 30
- FWCI
- 9.70
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Institut National de la Santé et de la Recherche Médicale
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Keywords
- deep infiltrating endometriosis, pelvic pain, dysmenorrhea, dyspareunia, chronic pelvic pain, bowel endometriosis, vaginal endometriosis, urinary tract symptoms, gastrointestinal symptoms, preoperative assessment, parity, body mass index
- MeSH terms
- Adult, Urinary Bladder, Defecation, Digestive System, Dysmenorrhea, Dyspareunia, Endometriosis, Female, Humans, Menstruation, Retrospective Studies, Urinary Tract, Uterus, Vagina, Body Mass Index, Logistic Models, Pelvic Pain
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