Margueritte François, Afraoucene Amel, Furdui Ramona, Armengaud Camille, Fauconnier Arnaud
Service de gynécologie obstétrique, centre hospitalier Intercommunal de Poissy Saint Germain en Laye, 10, rue du champ Gaillard, 78300 Poissy, France; Équipe RISCQ « Risques cliniques et sécurité en santé des femmes et en santé périnatale » (RISCQ), université Paris-Saclay, UVSQ, Montigny-le-Bretonneux, France.
Service de gynécologie obstétrique, centre hospitalier Intercommunal de Poissy Saint Germain en Laye, 10, rue du champ Gaillard, 78300 Poissy, France.
Gynecol Obstet Fertil Senol. 2023 Feb;51(2):111-116. doi: 10.1016/j.gofs.2022.12.004. Epub 2023 Jan 6.
A significant proportion of women with suspected endometriosis present neuropathic pain. The aim of this study is to assess this prevalence and the relevance of specific tests used.
This is a single-center retrospective study in the CHI of Poissy Saint Germain en Laye with patients who were referred for suspected endometriosis and who benefited from evaluation of neuropathic pain by two distinct questionnaires. The PAINdetect was evaluated by a series of 7 questions scored from 0 to 5 with a positive test if score>18. For the DN4, 7 binary questions were asked and 3 other questions were related to the clinical examination with a positivity threshold reached if score≥4 and in the absence of clinical examination if score≥3.
From November 2020 to June 2022, 57 patients were examined with a prevalence of neuropathic pain (one of the two test positive) evaluated at 36.8%. PAINdetect and DN4 positivity rates were at 26.8% and 30.9%. A discordance was found in 14.8% of cases with a kappa coefficient calculated at 0.63. There was a significant association between radiological examination and neuropathic pain with more neuropathic pain when the radiological examination was negative (P=0.03). The myofascial syndrome was present in only 59.5% of the patients and wasn't associated with neuropathic pain (P=1.00).
Prevalence of neuropathic pain in case of suspected endometriosis appears to be high. This need to be confirmed in a multicenter study with also assessment of the validity of the two diagnostic tests.
相当一部分疑似子宫内膜异位症的女性存在神经性疼痛。本研究的目的是评估这种患病率以及所用特定检测方法的相关性。
这是一项在普瓦西圣日耳曼昂莱综合医院进行的单中心回顾性研究,研究对象为因疑似子宫内膜异位症而转诊且通过两种不同问卷对神经性疼痛进行评估的患者。PAINdetect通过一系列7个问题进行评估,评分从0到5,若得分>18则检测为阳性。对于DN4,询问了7个二元问题,另外3个问题与临床检查相关,若得分≥4则为阳性阈值,若未进行临床检查则得分≥3为阳性阈值。
从2020年11月至2022年6月,共检查了57例患者,神经性疼痛的患病率(两种检测之一为阳性)评估为36.8%。PAINdetect和DN4的阳性率分别为26.8%和30.9%。在14.8%的病例中发现不一致,计算的kappa系数为0.63。放射学检查与神经性疼痛之间存在显著关联,放射学检查为阴性时神经性疼痛更多(P = 0.03)。仅59.5%的患者存在肌筋膜综合征,且与神经性疼痛无关(P = 1.00)。
疑似子宫内膜异位症病例中神经性疼痛的患病率似乎较高。这需要在多中心研究中得到证实,同时还需评估这两种诊断检测的有效性。