Atypical endometriosis revisited: clinical and biochemical evaluation of the different forms of superficial implants

Abstract

Objective: To investigate the activity of different forms of endometriosis implants by clinical and biochemical evaluation. Design: Prospective, blinded study. Setting: Tertiary-care university hospital. Patient(s): Forty-seven infertile patients with minimal or mild endometriosis diagnosed at laparoscopy were included in the clinical investigation. Intervention(s): Patients were submitted to a preoperative evaluation of endometriosis-associated dysmenorrhea by means of a 10-point linear analog scale and to laparoscopic staging of endometriosis following a current classification system. In the biochemical investigation, tissue samples from different endometriosis lesions and control tissues were assessed for prostaglandin (PG) F 2α production. Main Outcome Measure(s): Evaluation of the correlation between endometriosis-associated dysmenorrhea and the extent of the disease. Evaluation of the production of PGF 2α by the different tissues sampled. Result(s): No positive correlation was present between any of the implant subgroups and the associated dysmenorrhea. White peritoneal implants were associated with milder pain symptoms than black or red lesions. The biologic activity of red and black superficial implants, expressed as the production of PGF 2α, was similar. Conclusion(s): No positive correlation was demonstrated between endometriosis-associated dysmenorrhea and the current classification of endometriosis, which includes characterization of the different morphologic aspects of superficial endometriosis implants.