Case Based Discussion of Surgical Approach to Deep Infiltrating Endometriosis (WJGWH) - Iris Publishers
Case Based Discussion of Surgical Approach to Deep Infiltrating Endometriosis (WJGWH) - Iris Publishers
Case Based Discussion of Surgical Approach to Deep Infiltrating Endometriosis (WJGWH) - Iris Publishers
Endometriosis presents a diagnostic challenge as clinical symptoms
do not correlate well with the extent of disease [1]. Cramer, et al. [2] found
that menstrual cycle length shorter than 27 days, menses longer than 7 days and
severe cramping dysmenorrhea were predictive of endometriosis with relative
risks of 2.1 (95%CI 1.5-2.9), 2.4 (95%CI 1.4-4.0) and 6.7(95%CI 4.4-10.2)
respectively. The study compared 268 women with infertility and
laparoscopically confirmed endometriosis with 3794 women admitted for delivery
(controls) using a retrospective questionnaire. The study was limited by recall
bias and the criteria for laparoscopic diagnosis were not clearly defined. No
significant correlation was found with chronic pelvic pain. The issue has been
studied prospectively [3,4] in 134 women scheduled for laparoscopy for chronic
pelvic pain (CPP). Dyschezia, dyspareunia, and non-menstrual pain were all identified
as predictors of deep infiltrating endometriosis (DIE) with odds ratios of 3.9
(95%CI 1.7-8.9), 4.6 (95%CI 1.5-14.2) and 2.5 (95%CI 1.1-5.6) respectively.
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