Dyschezia and Posterior Deep Infiltrating Endometriosis: Analysis of 360 Cases

Abstract Study Objective To evaluate the relationship between anatomic locations and diameter of endometriotic lesions with severity of perimenstrual dyschezia (pain with defecation) as a possible location-indicating pain symptom for posterior deep infiltrating endometriosis (DIE). Design Retrospective analysis (Canadian Task Force classification II-3). Setting Tertiary care university hospital. Patients We reviewed hospital records of patients who underwent laparoscopic treatment for pelvic endometriosis in our center between 2001 and 2006. In all, 360 patients with posterior DIE (endometrial glands and stroma infiltrated excised tissues of the specified organs) were included for whom preoperative scoring of perimenstrual dyschezia was performed using a 10-point visual analog scale (VAS). Data about anatomic location and diameter of excised nodules were retrieved from operative and pathological records. Interventions Laparoscopic excision of suspected endometriotic lesions. Measurements and Main Results Mean VAS score of dyschezia for patients with overall posterior DIE was 3.9 ± 3.8, whereas in unaffected patients it was 1.9 ± 3.3 (Mann-Whitney test p Conclusion Severity of dyschezia was significantly correlated with posterior DIE. A positive correlation occurred between severity of dyschezia and lesion diameter with rectovaginal endometriosis but not with anterior rectal wall involvement.