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根据#ENZIAN标准,子宫内膜异位症的症状与类型之间是否存在关联?术前问卷的比较研究。

Is there a relationship between symptoms and types of endometriosis according to #ENZIAN? A comparative study of preoperative questionnaires.

作者信息

Piriyev Elvin, Mennicken Clara, Schiermeier Sven, Römer Thomas

机构信息

University Witten-Herdecke, Witten, Germany.

Department of Obstetrics and Gynecology, Academic Hospital Cologne Weyertal University of Cologne, Weyertal 76, 50933, Cologne, Germany.

出版信息

Arch Gynecol Obstet. 2025 Jun 28. doi: 10.1007/s00404-025-08072-w.

DOI:10.1007/s00404-025-08072-w
PMID:40580252
Abstract

OBJECTIVE

The primary objective was to evaluate the relationship between these three groups and digestive symptoms. The secondary objective was to evaluate all symptoms in all groups.

STUDY DESIGN

It was a retrospective comparative analysis of preoperative questionnaires. Three groups of patients were compared: Group 1 Patients with only peritoneal endometriosis ± adnexal adhesions and adenomyosis (P ± T and FA), Group 2 Patients with DIE, excluding the digestive system, and/or cystic ± peritoneal and adnexal adhesions and adenomyosis (O, A, B ± P, T, and FA), Group 3 Patients with DIE of the digestive system (C, FI) ± other localizations.

RESULTS

This retrospective study of 233 preoperative questionnaires explored symptom profiles across #ENZIAN-classified endometriosis types. No overall symptom differences were found, but severe dyschezia (VAS ≥ 5) correlated with bowel involvement (C compartment), dyspareunia corelated with adenomyosis (FA compartment), and chronic pelvic pain was lower in bowel DIE (Group 3) than in peritoneal/ovarian groups. Symptom questionnaires may guide surgical referral despite imaging limitations.

CONCLUSION

While these imaging modalities can help identify DIE and endometriomas, they are less effective in detecting superficial peritoneal lesions, which can also cause significant symptoms. For this reason, even though symptom questionnaires are not definitive diagnostic tools, they may serve as an important starting point for further investigation and referral for surgical evaluation.

摘要

目的

主要目的是评估这三组与消化系统症状之间的关系。次要目的是评估所有组中的所有症状。

研究设计

这是一项对术前问卷的回顾性比较分析。比较了三组患者:第1组仅患有腹膜子宫内膜异位症±附件粘连和子宫腺肌病的患者(P±T和FA);第2组患有深部浸润型子宫内膜异位症(DIE)但不包括消化系统,和/或囊性±腹膜及附件粘连和子宫腺肌病的患者(O、A、B±P、T和FA);第3组患有消化系统DIE(C、FI)±其他部位病变的患者。

结果

这项对233份术前问卷的回顾性研究探讨了#ENZIAN分类的子宫内膜异位症类型的症状特征。未发现总体症状差异,但严重排便困难(视觉模拟评分法[VAS]≥5)与肠道受累(C区)相关,性交困难与子宫腺肌病(FA区)相关,肠道DIE(第3组)的慢性盆腔疼痛低于腹膜/卵巢组。尽管存在影像学限制,但症状问卷可能有助于指导手术转诊。

结论

虽然这些影像学检查方法有助于识别DIE和子宫内膜瘤,但在检测浅表腹膜病变方面效果较差,而浅表腹膜病变也可引起明显症状。因此,尽管症状问卷不是确定性的诊断工具,但它们可能是进一步检查和转诊进行手术评估的重要起点。

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本文引用的文献

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Bladder Endometriosis: Diagnostic, Therapy, and Outcome of a Single-Center Experience.膀胱子宫内膜异位症:单中心经验的诊断、治疗及结果
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用于诊断盆腔深部子宫内膜异位症和子宫内膜异位症分类系统的非侵入性成像技术:国际共识声明。
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Evolution of Bowel Complaints after Laparoscopic Endometriosis Surgery: A 1497 Women Comparative Study.腹腔镜子宫内膜异位症手术后肠道症状的演变:一项 1497 名女性的比较研究。
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The #Enzian classification: A comprehensive non-invasive and surgical description system for endometriosis.恩齐安分类法:一种全面的非侵入性和手术性子宫内膜异位症描述系统。
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The epidemiology of endometriosis is poorly known as the pathophysiology and diagnosis are unclear.内异症的流行病学知识匮乏,因为其病理生理学和诊断仍不清楚。
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