Prevalence and severity of cyclic leg pain in women with endometriosis and in controls - effect of laparoscopic surgery

Eur J Obstet Gynecol Reprod Biol. 2014 Aug;179:51-7. doi: 10.1016/j.ejogrb.2014.05.027. Epub 2014 Jun 2.


Objective: In addition to dysmenorrhea, dyspareunia, and subfertility, pain in the lower extremities has been described to be a further complaint in women affected by endometriosis, and lysis of nerve entrapment was thought to be associated with amelioration of leg pain. Therefore, we aimed to compare the prevalence of cyclic leg pain and pain intensity between women with endometriosis and without endometriosis, and to evaluate the effect of laparoscopic surgery.

Study design: Forty-four women with endometriosis and 58 controls were included in a prospective, controlled clinical trial at a University hospital/tertiary referral center. Participants were asked to complete questionnaires the day before and six to nine weeks after laparoscopy. The prevalence and intensity of leg pain and improvement after laparoscopic surgery, quantified according to a visual analog scale (VAS) score, were evaluated. We also recorded involvement of dermatomes, the presence and intensity of dysmenorrhea, and correlations between age, stage of endometriosis (rAFS-score), and preoperative VAS scores.

Results: Before surgery, more women were affected by leg pain in the endometriosis group, compared to the control group (45.5% and 25.9%, respectively). Preoperative VAS scores for leg pain, however, were not significantly different between the two groups. A moderate correlation in the preoperative VAS scores between leg pain and dysmenorrhea was observed. After laparoscopy, we found a significant improvement in leg pain intensity in both groups. The mean difference in the VAS score for pain reduction between the study group and the control group was 0.74 (95% CI: -0.61-2.08), which was not statistically significant.

Conclusions: The prevalence of leg pain is increased in endometriosis, while leg pain intensity is not, compared to women without endometriosis. Laparoscopic surgery-even without preparation and decompression of nerve tissue-is associated with an improvement in pain intensity in women with endometriosis, as well as in the group without endometriosis.

Keywords: Endometriosis; Laparoscopic surgery; Laparoscopy; Leg pain; VAS score.

MeSH terms

  • Adult
  • Endometriosis / complications*
  • Endometriosis / surgery
  • Female
  • Humans
  • Laparoscopy*
  • Leg*
  • Middle Aged
  • Pain / diagnosis
  • Pain / epidemiology*
  • Pain / etiology
  • Pain Measurement
  • Prevalence
  • Prospective Studies
  • Severity of Illness Index
  • Treatment Outcome
  • Young Adult