Jimenez Jose Carlos Vilches, Romero Lucas Lozano, Garcia Ignacio Brunel, Sanchez Manuel Lozano, Fernandez Rodrigo Orozco
Department of Obstetrics and Gynecology, Hospital Quiron Salud Malaga, Spain.
Malaga University School of Medicine, Malaga, Spain.
Eur J Obstet Gynecol Reprod Biol X. 2023 Aug 9;19:100224. doi: 10.1016/j.eurox.2023.100224. eCollection 2023 Sep.
Endometriosis is a chronic oestrogen-dependent disease that affects 1 in 10 women of childbearing age. Half of these women have deep dyspareunia. The presence of this symptom has been shown to negatively affect your quality of life. There are few studies in the literature that address this issue and its pathophysiology remains poorly understood.
A case-control study has been carried out in order to assess the multi-causality of dyspareunia in patients with endometriosis. All the patients were assessed in a unit specialising in endometriosis and pelvic pain and their disease was staged using high-resolution ultrasound following the criteria of the IDEA group. The patients were divided into two groups, patients with dyspareunia n = 45 (cases) and those without it n = 55 (controls).
The only element that was statistically significant in explaining the dyspareunia was the presence of nodules in the retrocervical region with p = 0.000. The odds ratio of dyspareunia in the cases group was 5.3 (95 % CI 2.2-12.5).
Dyspareunia in patients with endometriosis is strongly dependent on the presence of nodules in the retrocervical region, although there are other factors involved that remain unknown, so more studies are still needed to understand and optimally address this symptom.
子宫内膜异位症是一种慢性雌激素依赖性疾病，影响着十分之一的育龄女性。这些女性中有一半患有深部性交疼痛。已表明这种症状的存在会对生活质量产生负面影响。文献中很少有研究涉及这个问题，其病理生理学仍知之甚少。
为评估子宫内膜异位症患者性交疼痛的多因素病因，开展了一项病例对照研究。所有患者均在一个专门治疗子宫内膜异位症和盆腔疼痛的科室接受评估，并根据国际子宫内膜异位症研究组（IDEA）的标准，使用高分辨率超声对其疾病进行分期。患者被分为两组，性交疼痛患者n = 45（病例组），无性交疼痛患者n = 55（对照组）。
在解释性交疼痛方面，唯一具有统计学意义的因素是宫颈后区域存在结节，p = 0.000。病例组性交疼痛的优势比为5.3（95%可信区间2.2 - 12.5）。
子宫内膜异位症患者的性交疼痛强烈依赖于宫颈后区域结节的存在，尽管还有其他未知因素参与其中，因此仍需要更多研究来理解并优化处理这一症状。
