Piriyev Elvin, Mennicken Clara, Schiermeier Sven, Römer Thomas
University Witten-Herdecke, Witten, Germany.
Department of Obstetrics and Gynecology, Academic Hospital Cologne Weyertal University of Cologne, Weyertal 76, 50933, Cologne, Germany.
Arch Gynecol Obstet. 2025 Jun 28. doi: 10.1007/s00404-025-08072-w.
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.
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.
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.
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.
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。
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。
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。
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。