Matorras R, Rodríguez F, Pijoan J I, Soto E, Pérez C, Ramón O, Rodríguez-Escudero F
Department of Obstetrics and Gynecology, Hospital of Cruces and País Vasco University, Baracaldo, Vizcaya, Spain.
Am J Obstet Gynecol. 1996 Feb;174(2):620-3. doi: 10.1016/s0002-9378(96)70438-6.
Our purpose was to assess the physical signs and clinical symptoms associated with endometriosis in infertile women.
This case-control study was carried out in an academic tertiary hospital. There were 174 infertile women with endometriosis and 174 infertile women without endometriosis, all of them studied by laparoscopy. Before laparoscopy a standard interview and a standard physical examination were performed.
Cul-de-sac nodularity was more frequent in infertile women with endometriosis than in infertile women without endometriosis (6.3% vs 0%). Although uterosacral tenderness was also more frequent in infertile women with endometriosis (7.5% vs 1.7%), uterosacral tenderness without nodularity was similar in both populations. Uterine retroversion and cul-de-sac obstruction frequencies were somewhat higher in the endometriosis group (p<0.10). The remaining signs and symptoms analyzed, including pelvic pain and dysmenorrhea, were similarly frequent in both populations. Symptoms were similarly frequent in all American Fertility Society stages, although adnexal mass was higher in stage IV.
Uterosacral nodularity was pathognomonic of endometriosis in infertile women. Uterosacral nodularity and uterosacral tenderness (associated with uterosacral nodularity) were the only symptoms or signs of value to indicate endometriosis in infertile patients. The remaining clinical signs, as well as clinical symptoms, were of no value in diagnosing endometriosis in infertile women.
我们的目的是评估与不孕女性子宫内膜异位症相关的体征和临床症状。
本病例对照研究在一家学术性三级医院进行。有174例患有子宫内膜异位症的不孕女性和174例未患子宫内膜异位症的不孕女性，所有患者均接受腹腔镜检查。在腹腔镜检查前进行了标准访谈和标准体格检查。
患有子宫内膜异位症的不孕女性直肠子宫陷凹结节比未患子宫内膜异位症的不孕女性更常见（6.3% 对0%）。虽然患有子宫内膜异位症的不孕女性子宫骶骨韧带触痛也更常见（7.5% 对1.7%），但无结节的子宫骶骨韧带触痛在两组人群中相似。子宫内膜异位症组子宫后倾和直肠子宫陷凹梗阻的发生率略高（p<0.10）。分析的其余体征和症状，包括盆腔疼痛和痛经，在两组人群中同样常见。所有美国生育协会分期的症状同样常见，尽管附件包块在IV期更高。
子宫骶骨韧带结节是不孕女性子宫内膜异位症的特征性表现。子宫骶骨韧带结节和子宫骶骨韧带触痛（与子宫骶骨韧带结节相关）是提示不孕患者子宫内膜异位症的唯一有价值的症状或体征。其余临床体征以及临床症状对诊断不孕女性的子宫内膜异位症无价值。
