Case–control study to develop and validate a questionnaire for the secondary prevention of endometriosis

Ricci, Giuseppe; Castelpietra, Elena; Romano, Federico; Lorenzo, Giovanni Di; Zito, Gabriella; Ronfani, Luca; Biffi, Stefania; Monasta, Lorenzo

doi:10.1371/journal.pone.0230828

Cited by 6 publications

(13 citation statements)

References 54 publications

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“…A significantly higher proportion of women with endometriosis (80.8%) used analgesics for a longer period of time during menses compared to women without endometriosis (51.1%), similar to a previous report [ 15 ]. However, they did not differentiate between the use and nonuse of hormonal contraception.…”

Section: Discussionsupporting

confidence: 90%

“…However, other significant pain parameters, such as throbbing, gnawing, and dragging pain to the legs were not found [ 14 ]. A questionnaire based upon 8 modules and 47 questions retained four significant variables, namely CPP, dyspareunia ≥ 3, painful defecation, and acne, with a final predictive logistic model for endometriosis with high sensitivity (0.902) and specificity (0.750) [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Predictive Model for the Non-Invasive Diagnosis of Endometriosis Based on Clinical Parameters

Konrad,

Fruhmann Berger,

Maier

et al. 2023

JCM

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Objectives: Are other pain symptoms in addition to dysmenorrhea, dyspareunia, dyschezia, dysuria, and chronic pelvic pain correlated to endometriosis and suitable for a clinical prediction model? Methods: We conducted a prospective study from 2016 to 2022, including a total of 269 women with numerous pain symptoms and other parameters. All women filled out two questionnaires and were examined by palpation and transvaginal ultrasound (TVUS). In cases of suspected deep endometriosis, magnetic resonance imaging (MRI) was performed. After the operation, endometriosis was diagnosed by histological examination. Results: All in all, 30 significant parameters and 6 significant numeric rating scale (NRS) scores associated with endometriosis could be identified: 7 pain adjectives, 8 endometriosis-associated pain symptoms, 5 pain localizations, 6 parameters from the PainDETECT, consumption of analgesics, and allergies. Furthermore, longer pain duration (before, during, and after menstruation) was observed in women with endometriosis compared to women without endometriosis (34.0% vs. 12.3%, respectively). Although no specific pain for endometriosis could be identified for all women, a subgroup with endometriosis reported radiating pain to the thighs/legs in contrast to a lower number of women without endometriosis (33.9% vs. 15.2%, respectively). Furthermore, a subgroup of women with endometriosis suffered from dysuria compared to patients without endometriosis (32.2% vs. 4.3%, respectively). Remarkably, the numbers of significant parameters were significantly higher in women with endometriosis compared to women without endometriosis (14.10 ± 4.2 vs. 7.75 ± 5.8, respectively). A decision tree was developed, resulting in 0.904 sensitivity, 0.750 specificity, 0.874 positive predictive values (PPV), 0.802 negative predictive values (NPV), 28.235 odds ratio (OR), and 4.423 relative risks (RR). The PPV of 0.874 is comparable to the positive prediction of endometriosis by the clinicians of 0.86 (177/205). Conclusions: The presented predictive model will enable a non-invasive diagnosis of endometriosis and can also be used by both patients and clinicians for surveillance of the disease before and after surgery. In cases of positivety, as evaluated by the questionnaire, patients can then seek advice again. Similarly, patients without an operation but with medical therapy can be monitored with the questionnaire.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Predictive Model for the Non-Invasive Diagnosis of Endometriosis Based on Clinical Parameters

Konrad,

Fruhmann Berger,

Maier

et al. 2023

JCM

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“…The predominant symptoms of endometriosis is pain in lower abdomen and it is diagnosed commonly in patients who manifest severe pelvic pain of prolonged nature. 16 Pelvic inflammatory disease(PID) was also one of the significant findings on diagnostic laparoscopy in patients with chronic pelvic pain. It was also significant finding in study done by various researchers.…”

Section: Discussionmentioning

confidence: 99%

Role of diagnostic laparoscopy in chronic pelvic pain in females: A study from tertiary care centre in Patna, Bihar

Singh¹,

Pankaj

Kumar³

et al. 2022

PJMS

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Chronic pelvic pain in females is one of the most bemusing problems that are faced by doctors in day to day practice as physical signs are nonspecific. Laparoscopy is one of the worthy tools in cases of chronic pelvic pain as not only it establishes the diagnosis but often treatment can be instituted in the same sitting. The present study aimed to evaluate whether diagnostic value of laparoscopy is worth in cases with chronic pelvic pain in females.This study was done in the department of General Surgery and Reproductive Medicine at Indira Gandhi Institute of Medical sciences, Patna, Bihar from July 2019 to March 2021. Seventy five female patients were included in this study. The analysis and interpretation of the data were performed using Microsoft excel. The quantitative data obtained were expressed as percentage in tabular form.: The studied patients were in the age group ranging from 15 – 65 years. Most patients 40 % (n=30) complaint of pain in right lower quadrant of abdomen. The most common finding during diagnostic laparoscopy was found to be tubercular pathology (22.67%) followed by pelvic adhesions (18.67%). Other diagnoses were pelvic inflammatory disease, endometriosis, cysts etc.Diagnostic Laparoscopy is a safe and effective tool to establish the aetiology of chronic pelvic pain and allows for appropriate interventions. It can serve as a time saving and cost effective implement for these patients with uncertain diagnosis.

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“…However, not all lower abdominal pain is caused by endometriosis. According to Ricci et al, endometriosis is diagnosed more often in patients who report severe and prolonged pelvic pain [ 19 ]. Pelvic pain is a symptom that can also be caused by disorders of the urinary, digestive, nervous, and musculoskeletal systems.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Diagnostic Accuracy of the Interview and Physical Examination in the Diagnosis of Endometriosis as the Cause of Chronic Pelvic Pain

Nawrocka-Rutkowska

Szydłowska

Rył

et al. 2021

IJERPH

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Background: Chronic pelvic pain affects approximately 15% of reproductive age women. It is mainly caused by adhesions (20–40%). Despite CPP being the main symptom of endometriosis, the disease is confirmed by laparoscopy only in 12–18% of cases. The aim of this study was to evaluate the results of laparoscopy in women with CCP and to assess the sensitivity and specificity of elements of an interview and clinical examination. Materials and methods: The study included 148 women with CPP. Each patient underwent laparoscopy. In laparoscopy, the presence of endometriosis and/or peritoneal adhesions was confirmed. Then, the sensitivity and specificity and the positive and negative predictive value of endometriosis symptoms or abnormalities in the gynecological examination were statistically calculated. Results: After previous surgery, adhesions were found in almost half (47%) of patients. In patients without a history of surgery, adhesions were diagnosed in 6.34% of patients. Endometriosis without coexisting adhesions was more often diagnosed in women without previous surgery (34.9%), compared to 10.58% in the group with a history of surgery (p < 0.05). Conclusions: Intraperitoneal adhesions are most common in women after pelvic surgery and with chronic ailments. The best results for sensitivity, specificity, positive predictive value, and negative predictive value in the diagnosis of endometriosis are found in women with irregular menstruations during which the pain increases. Laparoscopy still remains the primary diagnostic and therapeutic method for these women.

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Case–control study to develop and validate a questionnaire for the secondary prevention of endometriosis

Cited by 6 publications

References 54 publications

Predictive Model for the Non-Invasive Diagnosis of Endometriosis Based on Clinical Parameters

Predictive Model for the Non-Invasive Diagnosis of Endometriosis Based on Clinical Parameters

Role of diagnostic laparoscopy in chronic pelvic pain in females: A study from tertiary care centre in Patna, Bihar

Evaluation of the Diagnostic Accuracy of the Interview and Physical Examination in the Diagnosis of Endometriosis as the Cause of Chronic Pelvic Pain

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