Clinical, Anamnestic and Diagnostic Features of Patients with Different Stages and Localization of Endometriosis
S. V. Barinov,
O. V. Lazareva,
Yu. I. Tirskaya,
T. V. Kadtsyna,
Yu. I. Tshulovsky,
Ye. A. Khoroshkin,
L. L. Shkabarnya,
A. N. Ellert,
I. I. Sidorina https://doi.org/10.52420/umj.24.1.26
EDN: CTWXUI
Abstract
The aim of the study — to find the features of the history, symptoms, laboratory and ultrasound data in patients with different stages and localization of endometriosis.
Materials and methods. This retrospective controlled study included 99 patients with different stages according to the rASRM and localization of endometriosis who were divided into 3 groups: A1 (n = 34) — women with deep infiltrating endometriosis (DIE); A2 (n = 17) — with stages III–IV endometriosis without infiltration; B (n = 48) — with stages I–II ovarian endometriosis (OMA).
Results. The severity of pain according to the visual analogue scale was 4 [3; 6]: A1 — 5.00 [4.00; 6.75]; A2 — 6.00 [4.00; 7.00]; B — 4.00 [2.00; 5.50] (p = 0.050). The duration of the symptoms of endometriosis was 8 [3; 36] months: A1–12 [6; 36]; A2 — 24 [7; 60]; B — 6 [1;24] (p = 0.010). According to the transvaginal ultrasound enlargement of the adnexa was found in 86/99 patients: A1 — 27/34; A2 — 11/17; B — 48/48 patients (p = 0.009). Intraoperatively adhesions were found in 86/99 patients: A1 & A2 — 48/51; B — 38/48 patients (p = 0.028).
Conclusion. Women with DIE and stages III–IV endometriosis have a more severe chronic pelvic pain than women with stages I–II OMA. The severity of pain has no connection with the presence of intrapelvic adhesions. Adhesions of the pelvic organs are more often found in women with stages III–IV endometriosis. Transvaginal ultrasound is an effective imaging method for diagnosing OMA and DIE.
About the Authors
S. V. Barinov
Omsk State Medical University
Russian Federation
Competing Interests:
Russian Federation
Sergey V. Barinov — Doctor of Sciences (Medicine), Professor, Head of the Department of Obstetrics and Gynecology No. 2
Omsk
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest.
O. V. Lazareva
Omsk State Medical University
Russian Federation
Competing Interests:
Russian Federation
Oksana V. Lazareva — Candidate of Sciences (Medicine), Associate Professor of the Department of Obstetrics and Gynecology No. 2
Omsk
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest.
Yu. I. Tirskaya
Omsk State Medical University
Russian Federation
Competing Interests:
Russian Federation
Yuliya I. Tirskaya — Doctor of Sciences (Medicine), Associate Professor, Professor of the Department of Obstetrics and Gynecology No. 2
Omsk
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest.
T. V. Kadtsyna
Omsk State Medical University
Russian Federation
Competing Interests:
Russian Federation
Tatyana V. Kadtsyna — Candidate of Sciences (Medicine), Associate Professor of the Department of Obstetrics and Gynecology No. 2
Omsk
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest.
Yu. I. Tshulovsky
Omsk State Medical University
Russian Federation
Competing Interests:
Russian Federation
Yurij I. Tshulovsky — Candidate of Sciences (Medicine), Associate Professor of the Department of Obstetrics and Gynecology No. 2
Omsk
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest.
Ye. A. Khoroshkin
Omsk State Medical University
Russian Federation
Competing Interests:
Russian Federation
Yegor A. Khoroshkin — Clinical Resident of the Department of Obstetrics and Gynecology No. 2
Omsk
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest.
L. L. Shkabarnya
Regional Clinical Hospital
Russian Federation
Competing Interests:
Russian Federation
Lyudmila L. Shkabarnya — Head of the Department of Gynecology, Perinatal Centre
Omsk
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest.
A. N. Ellert
Regional Clinical Hospital
Russian Federation
Competing Interests:
Russian Federation
Alyona N. Ellert — Obstetrician-Gynecologist of the Department of Gynecology, Perinatal Centre
Omsk
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest.
I. I. Sidorina
Regional Clinical Hospital
Russian Federation
Competing Interests:
Russian Federation
Irina I. Sidorina — Obstetrician-Gynecologist of the Department of Gynecology, Perinatal Centre
Omsk
Competing Interests:
The authors declare the absence of obvious or potential conflict of interest.
References
1. Horne AW, Missmer SA. Pathophysiology, diagnosis, and management of endometriosis. BMJ. 2022; 379:e070750. DOI: https://doi.org/10.1136/bmj-2022-070750.
2. Taylor HS, Kotlyar AM, Flores VA. Endometriosis is a chronic systemic disease: clinical challenges and novel innovations. The Lancet. 2021;397(10276):839–852. DOI: https://doi.org/10.1016/S0140-6736(21)00389-5.
3. Horton J, Sterrenburg M, Lane S, Maheshwari A, Li TC, Cheong Y. Reproductive, obstetric, and perinatal outcomes of women with adenomyosis and endometriosis: A systematic review and meta-analysis. Human Reproduction Update. 2019;25(5):592–632. DOI: https://doi.org/10.1093/humupd/dmz012.
4. Della Corte L, Di Filippo C, Gabrielli O, Reppuccia S, La Rosa V L, Ragusa R, et al. The burden of endometriosis on women’s lifespan: A narrative overview on quality of life and psychosocial wellbeing. International Journal of Environmental Research and Public Health. 2020;17(13):4683. DOI: https://doi.org/10.3390/ijerph17134683.
5. Bonavina G, Taylor HS. Endometriosis-associated infertility: From pathophysiology to tailored treatment. Frontiers in Endocrinology. 2022;13:1020827. DOI: https://doi.org/10.3389/fendo.2022.1020827.
6. Chapron C, Marcellin L, Borghese B, Santulli P. Rethinking mechanisms, diagnosis and management of endometriosis. Nature Reviews Endocrinology. 2019;15(11):666–682. DOI: https://doi.org/10.1038/s41574-019-0245-z.
7. Dunselman GAJ, Beets-Tan RGH. Diagnosis of Endometriosis: Imaging. In: Giudice LC, Evers JLH, Healy DL (eds.). Endometriosis: Science and practice. Oxford: Wiley-Blackwell.; 2012. P. 299–308. DOI: https://doi.org/10.1002/9781444398519.ch29.
8. Yarmolinskaya MI, Rusina EI, Khachaturyan AR, Florova MS. Clinical picture and diagnosis of genital endometriosis. Journal of Obstetrics and Women’s Diseases. 2016;65(5):4–21. (In Russ.). DOI: https://doi.org/10.17816/JOWD6554-21.
9. Bulun SE, Yilmaz BD, Sison C, Miyazaki K, Bernardi L, Liu Sh, et al. Endometriosis. Endocrine Reviews. 2019;40(4):1048–1079. DOI: https://doi.org/10.1210/er.2018-00242.
10. Martire FG, Lazzeri L, Conway F, Siciliano T, Pietropolli A, Piccione E, et al. Adolescence and endometriosis: Symptoms, ultrasound signs and early diagnosis. Fertility and Sterility. 2020;114(5):1049–1057. DOI: https://doi.org/10.1016/j.fertnstert.2020.06.012.
11. Fong YF, Hon SK, Low LL, Lim Mei Xian K. The clinical profile of young and adolescent women with laparoscopically diagnosed endometriosis in a Singapore tertiary hospital. Taiwanese Journal of Obstetrics and Gynecology. 2017;56(2):181–183. DOI: https://doi.org/10.1016/j.tjog.2016.07.013.
12. Chapron C, Lafay-Pillet MC, Santulli P, Bourdon M, Maignien C, Gaudet-Chardonnet A, et al. A new validated screening method for endometriosis diagnosis based on patient questionnaires. eClinicalMedicine. 2022;44:101263. DOI: https://doi.org/10.1016/j.eclinm.2021.101263.
13. Markham R, Luscombe GM, Manconi F, Fraser IS. A detailed profile of pain in severe endometriosis. Journal of Endometriosis and Pelvic Pain Disorders. 2019:11(2):85–94. DOI: https://doi.org/10.1177/2284026519838948.
14. Popov AA, Manannikova TN, Chanturia TZ, Ramazanov MR, Fedorov AA, Slobodyanyuk BA. Comparative analysis of different forms of endometrioid disease: Case-control study. Kuban Scientific Medical Bulletin. 2012;(4):86–88. (In Russ.). EDN: https://elibrary.ru/pvrdif.
15. Efimenko TO. The structure, nature and intensity of pain in various forms of external genital endometriosis. Journal Of Obstetrics and Women’s Diseases. 2016:65(2):24–30. (In Russ.). DOI: https://doi.org/10.17816/JOWD65224-30.
16. Falcone T, Flyckt R. Clinical management of endometriosis. Obstetrics & Gynecology. 2018;131(3):557–571. DOI: https://doi.org/10.1097/AOG.0000000000002469.
17. Borisova AV, Kozachenko AV, Frankevich VE, Chagovets VV, Kononikhin AS, Starodubtseva NL, et al. Risk factors for recurrence of external genital endometriosis after surgical treatment: Prospective cohortant study. Medical Council. 2018;(7):32–38. (In Russ.). DOI: https://doi.org/10.21518/2079-701X-2018-7-32-38.
18. Chamié LP, Ribeiro DMFR, Tiferes DA, Macedo Neto AC, Serafini PC. Atypical sites of deeply infiltrative endometriosis: Clinical characteristics and imaging findings. RadioGraphics. 2018;38(1):309–328. DOI: https://doi.org/10.1148/rg.2018170093.
19. Carson SA, Kallen AN. Diagnosis and management of infertility: A review. JAMA. 2021;326(1):65–76. DOI: https://doi.org/10.1001/jama.2021.4788.
20. Gruber TM, Mechsner S. Pathogenesis of endometriosis: The origin of pain and subfertility. Cells. 2021; 10(6):1381. DOI: https://doi.org/10.3390/cells10061381.
21. Begovich Yo, Solopova AG, Khlopkova SV, Son YeA, Ungiadze DYu, Idrisova LE. Assessing sexual dysfunction in patients with external genital endometriosis. Obstetrics, Gynecology and Reproduction. 2022; 16(4):354–364. (In Russ.). DOI: https://doi.org/10.17749/2313-7347/ob.gyn.rep.2022.345.
22. Orazov MR, Radzinsky VE, Mikhaleva LM, Khamoshina MB, Bekulova MA. Dyspareunia as a hallmark of infiltrative forms of endometriosis. Difficult Patient. 2021:19(1):18–22. (In Russ.). DOI: https://doi.org/10.24412/2074-1995-2021-1-18-22.
23. Shum LK, Bedaiwy MA, Allaire C, Williams C, Noga H, Albert A, et al. Deep dyspareunia and sexual quality of life in women with endometriosis. Sexual Medicine. 2018;6(3):224–233. DOI: https://doi.org/10.1016/j.esxm.2018.04.006.
24. Wahl KJ, Orr NL, Lisonek M, Noga H, Bedaiwy MA, Williams C, et al. Deep dyspareunia, superficial dyspareunia, and infertility concerns among women with endometriosis: A cross-sectional study. Sexual Medicine. 2020;8(2):274–281. DOI: https://doi.org/10.1016/j.esxm.2020.01.002.
25. Barinov SV, Lazareva OV, Ignatyev YT, Poluektov VL, Mozgovoy SI, Poluektov VV, et al. Actual issues of diagnosis of deep infiltrative endometriosis. Mother and Baby in Kuzbass. 2020:80(1):10–17. (In Russ.). EDN: https://www.elibrary.ru/hzgepb.
26. Abd El-Kader AI, Gonied AS, Lotfy Mohamed M, Lotfy Mohamed S. Impact of endometriosis-related adhesions on quality of life among infertile women. International Journal of Fertility and Sterility. 2019; 13(1):72–76. DOI: https://doi.org/10.22074/ijfs.2019.5572.
Supplementary files
Review
For citations:
Barinov SV, Lazareva OV, Tirskaya YI, Kadtsyna TV, Tshulovsky YI, Khoroshkin YA, Shkabarnya LL, Ellert AN, Sidorina II. Clinical, Anamnestic and Diagnostic Features of Patients with Different Stages and Localization of Endometriosis. Ural Medical Journal. 2025;24(1):26–38. (In Russ.) https://doi.org/10.52420/umj.24.1.26. EDN: CTWXUI
Views:
127
Email this article 