Endometriosis-associated pelvic pain: Evidence for an association between the stage of disease and a history of chronic pelvic pain

Objective: To track the severity and location of pelvic pain associated with endometriosis throughout the reproductive-age years and to evaluate the association between these pain parameters and the stage of disease. Design: Historical prospective study. Setting: Tertiary care center. Patient(s): Forty-eight women with endoscopically staged endometriosis and chronic pelvic pain who had undergone medical and/or conservative surgical therapy. Intervention(s): Each participant was administered a questionnaire that included a determination of the severity and location of her pain. Main Outcome Measure(s): The stage of disease, the area of the pelvis that contained the bulk of disease, the severity of pain, and the location of the most severe pain were recorded. Result(s): The mean duration from the initial diagnosis until follow-up was 15.7 +/- 3.1 years. Twenty-one (43.8%) subjects denied any symptoms of pain on follow-up evaluation. Of the 27 patients with persistent pain, 21 (78%) identified the location of their most severe pain as being the same as at initial diagnosis. The stage of disease at initial diagnosis was significantly associated with a higher degree of pain at follow-up. Conclusion(s): These data suggest that endometriosis-associated chronic pelvic pain commonly persists throughout the reproductive years and that endometriosis stage is directly related to the persistence of pelvic pain. (C) 1997 by American Society for Reproductive Medicine.