CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2020; 80(03): 307-315
DOI: 10.1055/a-1033-9588
GebFra Science
Original Article/Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

Cycle-related Diarrhea and Dysmenorrhea are Independent Predictors of Peritoneal Endometriosis, Cycle-related Dyschezia is an Independent Predictor of Rectal Involvement

Article in several languages: English | deutsch
Kristin Nicolaus
Klinik und Poliklinik für Frauenheilkunde und Fortpflanzungsmedizin des Universitätsklinikums Jena, Friedrich-Schiller-Universität Jena, Jena, Germany
,
Laura Reckenbeil
Klinik und Poliklinik für Frauenheilkunde und Fortpflanzungsmedizin des Universitätsklinikums Jena, Friedrich-Schiller-Universität Jena, Jena, Germany
,
Dominik Bräuer
Klinik und Poliklinik für Frauenheilkunde und Fortpflanzungsmedizin des Universitätsklinikums Jena, Friedrich-Schiller-Universität Jena, Jena, Germany
,
Robert Sczesny
Klinik und Poliklinik für Frauenheilkunde und Fortpflanzungsmedizin des Universitätsklinikums Jena, Friedrich-Schiller-Universität Jena, Jena, Germany
,
Herbert Diebolder
Klinik und Poliklinik für Frauenheilkunde und Fortpflanzungsmedizin des Universitätsklinikums Jena, Friedrich-Schiller-Universität Jena, Jena, Germany
,
Ingo B. Runnebaum
Klinik und Poliklinik für Frauenheilkunde und Fortpflanzungsmedizin des Universitätsklinikums Jena, Friedrich-Schiller-Universität Jena, Jena, Germany
› Author Affiliations
Further Information

Publication History

received 23 July 2019
revised 19 October 2019

accepted 22 October 2019

Publication Date:
04 March 2020 (online)

  

Abstract

Introduction The clinical presentation of endometriosis is extremely varied. Because endometriosis symptoms may overlap with symptoms caused by gastroenterological disorders, this can lead to misdiagnosis and a considerable delay in arriving at the correct diagnosis. The aim was to evaluate the type and duration of endometriosis-related symptoms and to identify predictors for patterns of involvement depending on symptoms.

Material and Method The data of 266 consecutive patients who were operated on in the Endometriosis Center between 1/2016 and 12/2017 after receiving a histologically verified diagnosis of endometriosis were recorded. In addition to recording the clinical parameters, a questionnaire was distributed to the patients, who were asked about their medical history. Infertile patients were grouped together as Group 1 and compared to non-infertile patients (Group 2).

Results The response rate for returned questionnaires was 79.47% (182/229). 41.8% of patients reported that they were infertile and 91.8% reported pelvic pain. In more than ⅓ of cases in both groups, more than 10 years passed between the initial symptoms and the final diagnosis (39.4 vs. 37.5%). On average, patients consulted 2.72 (± 1.58) resp. 3.08 (± 1.72) doctors before they presented to a hospital or were referred for laparoscopic diagnostic workup (p = 0.162). Cycle-related diarrhea (odds ratio 2.707; 95% CI: 1.063 – 6.895, p = 0.037) and dysmenorrhea (odds ratio 2.278; 95% CI: 1.193 – 4.348, p = 0.013) were associated with involvement of the pelvic peritoneum, cycle-related dyschezia was associated with rectal involvement by a factor of 4.6 in binary regression analysis (odds ratio 4.659; 95% CI: 1.132 – 19.186; p = 0.033).

Conclusion Cycle-related diarrhea and dysmenorrhea increase the risk probability of peritoneal endometriosis. Dyschezia increases the risk probability of rectal endometriosis.