OC10.05: Can we predict pouch of Douglas obliteration using sonovaginography in women with chronic pelvic pain?

Background: Endometriosis is considered as the chronic benign gynecologic disease which can cause chronic pelvic pain (CPP) and infertility. Endometriosis has affected almost 10% of the women of reproductive age.Methods: Thirty women diagnosed with endometriosis were studied. Pain intensity was assessed by visual analogue scale (VAS) and categorized as mild, moderate or severe accordingly. This was followed by laparoscopy/ laparotomy and staging of endometriosis which was done as per the American Society for Reproductive Medicine (ASRM) classification system. Corrective procedures were done simultaneously.Results: Mean age of women with endometriosis was 30±5.75 years. Majority had superficial implants (30%), 6.66% had deep implants and 6.66% had combination of superficial and deep implants. There was no significant difference between implants and severity of pain (p=0.069). There was a significant association between severity of pain with obliteration of POD. Significant association was seen between deeply infiltrating endometriosis (DIE) represented by the pouch of Douglas (POD) obliteration and severity of pain.Conclusions: Severity of pain was significantly associated with deeply infiltrating endometriosis (DIE) represented by the pouch of Douglas (POD) obliteration. However, no association was obtained between severities of pain with superficial implants.

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CLINICAL CHARACTERISTICS OF PATIENTS WITH EXTERNAL GENITAL ENDOMETRIOSIS

Sibirskij medicinskij vestnik ◽

10.31549/2541-8289-2021-2-3-8 ◽

2021 ◽

pp. 3-8

Author(s):

Yu.S. Timofeeva ◽

◽

A.V. Volchek ◽

V.M. Kuleshov ◽

S.V. Aidagulova ◽

...

Keyword(s):

Pelvic Pain ◽

Clinical Characteristics ◽

Chronic Pelvic Pain ◽

Clinical Signs ◽

Pairwise Comparison ◽

Newly Diagnosed ◽

Exact Test ◽

Uterine Ligaments ◽

Pouch Of Douglas ◽

Uterine Body

A pairwise comparison of the clinical characteristics of patients with external genital endometriosis (EGE) stages I–III was carried out using Fisher's exact test. Patients with the most common (and newly diagnosed) stage II showed the greatest number of statistically significant correlations between clinical signs: dysmenorrheas with primary infertility (p = 0,0201), with localization of endometrioid heterotopias in the pouch of Douglas (p = 0,0214) and sacro-uterine ligaments (p = 0,0259); in addition, a relationship was found between the symptom of chronic pelvic pain and the presence of endometrioid heterotopias in the uterovesical space (p = 0,0071) and on the sacro-uterine ligaments (p = 0,0228). Along with this, they have a combination of foci of adenomyosis with multiple myoma of the uterine body was noted (p = 0,0000). In patients with stage III EGE, only one statistically significant (p = 0,0139) contingency of clinical signs was revealed — dyspareunia and heterotopias on the sacro-uterine ligaments.

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