Peritoneal endometriosis: Morphologic appearance in women with chronic pelvic pain

P. Vercellini, L. Bocciolone, N. Vendola, A. Colombo, M. T. Rognoni, L. Fedele

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Abstract

A prospective study analyzed the prevalence and severity of dysmenorrhea, intermenstrual pain and deep dyspareunia in relation to morphologic features of peritoneal disease in 73 consecutive women with endometriosis but no associated pelvic pathology, previous pelvic surgery or hormonal treatment. All underwent their first laparoscopy for chronic pelvic pain at the First Department of Obstetrics and Gynecology, University of Milan, Milan, Italy, between 1986 and 1989. Gynecologic pain symptoms were evaluated with a verbal score and visual analog scale. Peritoneal lesions were classified as typical (black nodules, yellow-brown patches, stellate scars), atypical (clear vesicles, clear or red papules, red polypoid lesions) or mixed. When the three types of lesions were considered together, a statistically significant association was observed only with deep dyspareunia (P <.01). Moreover, a significantly higher prevalence of deep dyspareunia was revealed in patients with typical versus atypical lesions (P <.01) and in those with mixed versus atypical lesions (P <.05). Fresh, papular, atypical lesions exposed to peritoneal fluid might cause functional pain, whereas 'old,' black nodules immersed in infiltrating scars might provoke mainly organic pain.

Original languageEnglish
Pages (from-to)533-536
Number of pages4
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume36
Issue number7
Publication statusPublished - 1991

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ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Reproductive Medicine

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