Correlation between MR-semiotics and relapse of pelvic pain syndrome in patients with external genital endometriosis

Abstract

Introduction. Endometriosis is a pathological process when tissue similar by morphological and functional properties to the endometrium located outside the uterine cavity. Endometriosis presents with debilitating painful symptoms. Despite treatment, persistence and recurrence of symptoms of endometriosis is common. Diagnostic imaging is essential for treatment planning. Clinical manifestation. To determine the relationship between the localization of foci of external genital endometriosis and relapse of pelvic pain syndrome. Materials and methods. А retro- and prospective analysis of MRI examinations of the pelvic organs in 80 patients with pelvic pain syndrome, aged from 24 to 39 years. The intensity of the pain syndrome was assessed using a visual analogue scale (VAS). The study involved patients with various localizations of external genital endometriosis: ovarian endometriosis, pelvic peritoneum endometriosis, broad ligaments, posterior pelvic compartment vis, rectum with deep and superficial invasion. Results. No statistically significant relationship between ovarian endometriosis and pelvic pain syndrome recurrence at 6 months (p=0.574). A statistically significant relationship was obtained between the endometrial implants in the retrouterine space and the recurrence of pelvic pain syndrome (p <0.001). A statistically significant relationship was obtained between the depth rectal wall invasion in endometriosis of the retrouterine space between the recurrence of pelvic pain syndrome (p <0.001). A statistically significant relationship was found between recurrence of pelvic pain syndrome and endometriosis of the peritoneum (p=0.018) and endometriosis of the broad ligament (p=0.03). Conclusion. According to our study, the most recurrent pelvic pain syndrome localizations of endometriosis according to MRI were: endometriosis of the retrouterine space, endometriosis of the peritoneum, round ligament of the uterus, endometriosis of the rectal wall. Statistically significant relationship was found between the depth of intestinal invasion and the recurrence of pelvic pain syndrome.