The role of clinical and anamnestic data in the primary diagnosis of genital endometrios
DOI:
https://doi.org/10.14739/2310-1237.2024.1.297162Keywords:
genital endometriosis, signs and symptoms, diagnosisAbstract
To date, many randomized studies have proven the importance of evaluating clinical and anamnestic data in the initial diagnosis of genital endometriosis. Clinical assessment of “classic” complaints of patients, which are characteristic of genital endometriosis, allows to predict the presence of endometriosis with a high probability, which is an important component of choosing the optimal treatment tactics. Despite a fairly significant number of developed questionnaires for the assessment of endometriosis symptoms, none of them has been widely used among domestic clinicians. Implementation of a diary of symptoms of endometriosis in practice will allow to more carefully assess the general pain of endometriosis, the impact on the patient’s quality of life, and also to evaluate the quality of the chosen method of treatment.
The aim of the study: on the basis of a retrospective analysis of patients’ disease histories, assessment of the presence of clinical and anamnestic data characteristic of genital endometriosis in accordance with the obtained results of pathohistologically confirmed endometriosis.
Materials and methods. We performed a retrospective analysis of 160 patient histories. The criteria for selecting patients with genital endometriosis were the presence of the following symptoms: premenstrual pain syndrome, dysmenorrhea, dyspareunia, the nature of menstrual discharge (brown discharge before and after menstruation), chronic pelvic pain, as well as confirmation, with the help of histopathological examination, of genital endometriosis.
Results. By comparing the obtained data on pain symptoms with the clinical diagnosis made on the basis of histopathological examination, it can be concluded that the symptoms were most likely caused by endometriosis.
Conclusions. Clinical and anamnestic data most characteristic of genital endometriosis were found in 138 (86.25 %) patients, data on the frequency of combination of painful symptoms were as follows: combination of two symptoms in 27.50 % (n = 44), three symptoms in 26.88 % (n = 43), four symptoms in 14.38 % (n = 23) and five studied symptoms in 6.25 % (n = 10), which in turn influenced the choice of the expected volume of surgical intervention and contributed to the establishment of a clinical diagnosis. The description of pain symptoms is quite limited, since the assessment of the characteristic symptoms of genital endometriosis did not include: conducting additional examinations in order to exclude additional causes of functional pain in the pelvis, the description of pain symptoms was incomplete, which, in turn, minimized the assessment of the adverse impact on daily activities, work or the quality of life in general, characteristic of pain symptoms, there is no clear difference between chronic pelvic pain and dysmenorrhea, the absence of data regarding the work of the gastrointestinal tract and urinary system, regarding the symptoms of genital endometriosis, which may indicate damage to the above-mentioned departments.
References
van Nooten FE, Cline J, Elash CA, Paty J, Reaney M. Development and content validation of a patient-reported endometriosis pain daily diary. Health Qual Life Outcomes. 2018;16(1):3. doi: https://doi.org/10.1186/s12955-017-0819-1
Zondervan KT, Becker CM, Koga K, Missmer SA, Taylor RN, Viganò P. Endometriosis. Nat Rev Dis Primers. 2018;4(1):9. doi: https://doi.org/10.1038/s41572-018-0008-5
Daniilidis A, Angioni S, Di Michele S, Dinas K, Gkrozou F, D'Alterio MN. Deep Endometriosis and Infertility: What Is the Impact of Surgery? J Clin Med. 2022;11(22):6727. doi: https://doi.org/10.3390/jcm11226727
D’Alterio MN, Saponara S, Agus M, Laganà AS, Noventa M, Loi ES, et al. Medical and surgical interventions to improve the quality of life for endometriosis patients: a systematic review. Gynecol Surg. 2021;18(1). doi: https://doi.org/10.1186/s10397-021-01096-5
Szypłowska M, Tarkowski R, Kułak K. The impact of endometriosis on depressive and anxiety symptoms and quality of life: a systematic review. Front Public Health. 2023;11:1230303. doi: https://doi.org/10.3389/fpubh.2023.1230303
Till SR, As-Sanie S, Schrepf A. Psychology of Chronic Pelvic Pain: Prevalence, Neurobiological Vulnerabilities, and Treatment. Clin Obstet Gynecol. 2019;62(1):22-36. doi: https://doi.org/10.1097/GRF.0000000000000412
Estes SJ, Huisingh CE, Chiuve SE, Petruski-Ivleva N, Missmer SA. Depression, Anxiety, and Self-Directed Violence in Women With Endometriosis: A Retrospective Matched-Cohort Study. Am J Epidemiol. 2021;190(5):843-52. doi: https://doi.org/10.1093/aje/kwaa249
Arena A, Orsini B, Degli Esposti E, Manzara F, Ambrosio M, Raimondo D, et al. The unbearable burden of endometriosis: Results from a large cohort about anxiety reduction during the first outpatient evaluation. J Psychosom Res. 2021;147:110512. doi: https://doi.org/10.1016/j.jpsychores.2021.110512
Stragapede E, Huber JD, Corsini-Munt S. My Catastrophizing and Your Catastrophizing: Dyadic Associations of Pain Catastrophizing and the Physical, Psychological and Relational Well-Being of Persons with Endometriosis and their Partners. Clin J Pain. 2024 Jan 17. doi: https://doi.org/10.1097/AJP.0000000000001193
Puchar A, Panel P, Oppenheimer A, Du Cheyron J, Fritel X, Fauconnier A. The ENDOPAIN 4D Questionnaire: A New Validated Tool for Assessing Pain in Endometriosis. J Clin Med. 2021;10(15):3216. doi: https://doi.org/10.3390/jcm10153216
Keukens A, Veth VB, Regis M, Mijatovic V, Bongers MY, Coppus SF, et al. The effect of surgery or medication on pain and quality of life in women with endometrioma. A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2024;293:95-105. doi: https://doi.org/10.1016/j.ejogrb.2023.12.012
Paterson ES, Scheck S, McDowell S, Bedford N, Girling JE, Henry CE. Retrospective review of endometriosis surgery at Te Whatu Ora - Capital and Coast. Aust N Z J Obstet Gynaecol. 2023 Oct 31. doi: https://doi.org/10.1111/ajo.13766
Mijatovic V, Vercellini P. Towards comprehensive management of symptomatic endometriosis: beyond the dichotomy of medical versus surgical treatment. Hum Reprod. 2024;39(3):464-77. doi: https://doi.org/10.1093/humrep/dead262
Andres MP, Riccio LG, Abrao HM, Manzini MS, Braga L, Abrao MS. Visual Analogue Scale Cut-off Point of Seven Represents Poor Quality of Life in Patients with Endometriosis. Reprod Sci. 2023 Dec 6. doi: https://doi.org/10.1007/s43032-023-01406-6
Yela DA, Silva MS, Eloy L, Benetti-Pinto CL. Correlation between Anatomopathological Aspects and Pelvic Pain in Women with Deep Infiltrating Endometriosis. Rev Bras Ginecol Obstet. 2023;45(12):e770-4. doi: https://doi.org/10.1055/s-0043-1772473
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