Vercellini P, Bocciolone L, Vendola N, Colombo A, Rognoni M T, Fedele L
Department of Obstetrics and Gynecology L. Mangiagalli, University of Milan, Italy.
J Reprod Med. 1991 Jul;36(7):533-6.
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 less than .01). Moreover, a significantly higher prevalence of deep dyspareunia was revealed in patients with typical versus atypical lesions (P less than .01) and in those with mixed versus atypical lesions (P less than .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.
一项前瞻性研究分析了73例患有子宫内膜异位症但无相关盆腔病变、既往盆腔手术史或激素治疗史的连续女性中痛经、经间期疼痛和深部性交痛的患病率及严重程度，并将其与腹膜疾病的形态学特征相关联。所有患者于1986年至1989年期间在意大利米兰大学妇产科第一科室因慢性盆腔疼痛接受了首次腹腔镜检查。妇科疼痛症状采用言语评分和视觉模拟量表进行评估。腹膜病变分为典型（黑色结节、黄褐色斑块、星状瘢痕）、非典型（清亮水疱、清亮或红色丘疹、红色息肉样病变）或混合型。当将这三种类型的病变综合考虑时，仅观察到与深部性交痛存在统计学显著关联（P<0.01）。此外，典型病变患者与非典型病变患者相比（P<0.01）以及混合型病变患者与非典型病变患者相比（P<0.05），深部性交痛的患病率显著更高。暴露于腹膜液中的新鲜、丘疹样、非典型病变可能导致功能性疼痛，而浸润在瘢痕中的“陈旧性”黑色结节可能主要引发器质性疼痛。
