Objective: To explore the association between endometriosis stage, characteristics of endometriotic lesions and severity of dysmenorrhoea.
Methods: The clinical data were collected from 140 patients with laparoscopically diagnosed endometriosis between May 2013 and December 2013. They were scored by visual analogue scale (VAS) according to their preoperative dysmenorrhoea. Endometriotic lesions were recorded by their anatomical distributions. And endometriosis was staged and scored according to the score of Revised American Fertility Society (r-AFS). The relationship between dysmenorrhoea and endometriosis stage as well as endometriotic foci was analyzed. Chi-square test and Logistic regression were used for statistical analyses.
Results: Among them, there were 95 (67.86%) patients with dysmenorrhoea and 45(32.14%) without dysmenorrhoea. No significant inter-group difference existed in age (P > 0.05). The interval from menarche to the onset of dysmenorrhoea was (8 ± 9) years and duration of dysmenorrhoea (2.3 ± 1.5) days each month. A correlation existed between endometriosis stage and severity of dysmenorrhoea (χ² = 20.677, P < 0.05). A strong association was found between posterior cul-de-sac obliteration and severity of dysmenorrhoea (χ² = 8.471, P < 0.05). No significant difference was found for ovarian endometriomas, ovarian adhesion, superficial peritoneal lesions and deep infiltrating endometriosis in non- and minimal dysmenorrhoea groups with moderate and severe dysmenorrhoea (P > 0.05). Posterior cul-de-sac obliteration was an independent influencing factor for dysmenorrhoea. The odds ratio (OR) was 3.291 and 95% confidence interval (CI) 1.453-7.454. However, no relevance existed between ovarian endometriomas and dysmenorrhoea by Logistic analysis.
Conclusion: The severity of dysmenorrhoea has close correlation with posterior cul-de-sac obliteration. However, there is a weak relevance with ovarian endometreaiomas.