Original Article

Archives of Gynecology and Obstetrics

, Volume 280, Issue 3, pp 369-373

First online:

The influence of peritoneal endometriotic lesions on the generation of endometriosis-related pain and pain reduction after surgical excision

  • Andrea KaiserAffiliated withDepartment of Gynaecology, Endometriosis Research Centre Charité, Charité, Campus Benjamin Franklin
  • , Andreas KopfAffiliated withDepartment for Anaesthesiology and Intensive Care, Charité, Campus Benjamin Franklin
  • , Christine GerickeAffiliated withInstitute of Biometry and Clinical Epidemiology, Charité, Campus Mitte
  • , Julia BartleyAffiliated withDepartment of Gynaecology, Endometriosis Research Centre Charité, Charité, Campus Benjamin Franklin
  • , Sylvia MechsnerAffiliated withDepartment of Gynaecology, Endometriosis Research Centre Charité, Charité, Campus Benjamin Franklin Email author 

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Abstract

Purpose

To investigate the influence of different kinds of endometriotic lesions, especially peritoneal endometriotic implants in pain generation and the pain reduction after surgical excision in a prospective study.

Methods

Fifty-one pre-menopausal patients underwent surgical laparoscopy due to chronic pelvic pain, dysmenorrhoea and/or for ovarian cysts. In 44 patients, endometriosis was diagnosed. The pre- and post-operative pain score was determined using a standardized questionnaire with a visual analogue scale. Patients with peritoneal endometriosis were divided into two different groups depending on their pre-operative pain score: group A had a pain score of 3 or more, while group B a pain score of 2 or less. Patients without peritoneal endometriosis were classified as group C, and patients without endometriosis were classified as group D. The pre- and post-operative pelvic pain and/or dysmenorrhoea was analysed according to the different types of endometriotic lesions.

Results

In groups A and C, the post-operative pain score decreased by at least 2 grades or more (p < 0.0). In group D, the post-operative pain score showed no significant reduction.

Conclusion

The present study suggests that the surgical excision of endometriotic lesions—including peritoneal implants—is an effective treatment of endometriosis-associated pelvic pain and/or dysmenorrhoea.

Keywords

Endometriosis Pelvic pain Dysmenorrhoea Pain transmission Pathophysiology of endometriosis-related pain Surgical excision