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SHR Neuro Cancer Cardio Lipid Metab Microb

Reiser, E; Göbel, G; Perricos-Hess, A; Buchweitz, O; Jaekel, M; Westphal, E; Rimbach, S; Woelfler, M; Kraemer, B; Kolben, T; Pempelfort, SD; Pashkunova, D; Metzler, J; Derihaci, RP; Klein, P; Janschek, E; Guttenberg, P; Wuester, M; Wolfrum, A; Seifert-Klauss, V; Enzelsberger, SH; Keckstein, J; Wenzl, R; Seeber, B.
Evaluation of the association between self-reported pre-operative symptoms with surgically diagnosed endometriosis using the #ENZIAN classification in a multi-centre cohort.
Hum Reprod. 2025; 40(9):1643-1650 Doi: 10.1093/humrep/deaf120 [OPEN ACCESS]
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STUDY QUESTION: Is there an association between pre-operative symptoms and intraoperatively described localization and size of endometriosis lesions as assessed by the #ENZIAN classification system? SUMMARY ANSWER: Dyschezia is associated with any deep infiltrating endometriosis (DE) lesions; severe dyspareunia is associated with adenomyosis. WHAT IS KNOWN ALREADY: Previous attempts to correlate the common symptoms of endometriosis to the size and localization of lesions have been of moderate success. STUDY DESIGN, SIZE, DURATION: This prospective, multicentre, non-interventional cross-sectional study was conducted between September 2022 and January 2024 at 18 endometriosis centres in Austria, Germany, and Switzerland, enrolling a total of 838 patients with endometriosis. PARTICIPANTS/MATERIALS, SETTING, METHODS: The study included 521 patients with complete information on pre-operative symptoms and intraoperatively diagnosed endometriosis classified by the #ENZIAN classification system. Associations between symptoms and localization of endometriosis lesions were analysed. MAIN RESULTS AND THE ROLE OF CHANCE: Nearly all patients (n = 513) (98.5%) suffered from dysmenorrhea whereas 294 (56.4%), 208 (39.9%), and 102 (19.6%) patients reported dyspareunia, dyschezia, and dysuria, respectively. Dyspareunia rated as ≥8 on a visual analogue scale was reported 3.5-fold more often in patients with adenomyosis only (OR 3.56 [1.38-9.17]) than in those without, while dyschezia was almost twice as likely in those with any form of DE (OR 1.86 [1.3-2.65]). LIMITATIONS, REASONS FOR CAUTION: A larger study population is needed to clinically define relevant sub-groups based on localization of lesions. WIDER IMPLICATIONS OF THE FINDINGS: The findings of the present study identify adenomyosis as a strong driver of pain, especially dyspareunia, making awareness of its high prevalence of utmost importance. Few direct associations between symptoms and lesions were identified. Endometriosis-related symptoms, especially when chronic, are multi-factorial and cannot be readily correlated to specific lesion sites. STUDY FUNDING/COMPETING INTEREST(S): This study received no external funding and all the authors declare they have no conflicts of interest pertaining to this study. TRIAL REGISTRATION NUMBER: Clinical Trials NCT05624567.

Find related publications in this database (using NLM MeSH Indexing)

Humans - administration & dosage

Female - administration & dosage

Endometriosis - surgery, diagnosis, complications, classification, pathology

Adult - administration & dosage

Cross-Sectional Studies - administration & dosage

Prospective Studies - administration & dosage

Dyspareunia - etiology

Dysmenorrhea - etiology

Self Report - administration & dosage

Switzerland - epidemiology

Austria - epidemiology

Middle Aged - administration & dosage

Germany - epidemiology

Preoperative Period - administration & dosage

Adenomyosis - complications

Pelvic Pain - etiology

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