The influence of peritoneal endometriotic lesions on the generation of endometriosis-related pain and pain reduction after surgical excision

Arch Gynecol Obstet. 2009 Sep;280(3):369-73. doi: 10.1007/s00404-008-0921-z. Epub 2009 Jan 16.


Purpose: To investigate the influence of different kinds of endometriotic lesions, especially peritoneal endometriotic implants in pain generation and the pain reduction after surgical excision in a prospective study.

Methods: Fifty-one pre-menopausal patients underwent surgical laparoscopy due to chronic pelvic pain, dysmenorrhoea and/or for ovarian cysts. In 44 patients, endometriosis was diagnosed. The pre- and post-operative pain score was determined using a standardized questionnaire with a visual analogue scale. Patients with peritoneal endometriosis were divided into two different groups depending on their pre-operative pain score: group A had a pain score of 3 or more, while group B a pain score of 2 or less. Patients without peritoneal endometriosis were classified as group C, and patients without endometriosis were classified as group D. The pre- and post-operative pelvic pain and/or dysmenorrhoea was analysed according to the different types of endometriotic lesions.

Results: In groups A and C, the post-operative pain score decreased by at least 2 grades or more (p < 0.0). In group D, the post-operative pain score showed no significant reduction.

Conclusion: The present study suggests that the surgical excision of endometriotic lesions -- including peritoneal implants -- is an effective treatment of endometriosis-associated pelvic pain and/or dysmenorrhoea.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Chronic Disease
  • Dysmenorrhea / etiology
  • Dysmenorrhea / surgery*
  • Endometriosis / complications
  • Endometriosis / surgery*
  • Female
  • Humans
  • Laparoscopy
  • Middle Aged
  • Ovarian Cysts / etiology
  • Ovarian Cysts / surgery*
  • Pain Measurement
  • Pelvic Pain / etiology
  • Pelvic Pain / surgery*
  • Peritoneum
  • Premenopause
  • Prospective Studies
  • Treatment Outcome
  • Young Adult