The influence of peritoneal endometriotic lesions on the generation of endometriosis-related pain and pain reduction after surgical excision
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- Kaiser, A., Kopf, A., Gericke, C. et al. Arch Gynecol Obstet (2009) 280: 369. doi:10.1007/s00404-008-0921-z
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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.
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.
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.
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.