Abstract
BackgroundEndometriosis is a debilitating gynecologic disease characterized by the implantation of endometrial tissue in ectopic locations, with signs of severe and chronic inflammation. The new knowledge on endometriosis has highlighted the value of secondary prevention through the early diagnosis and treatment of lesions to reduce serious consequences, first of all, infertility and chronic pelvic pain. The purpose of this study is to assess the reliability and validity of the questionnaire, as a tool to precociously identify women with endometriosis, to prevent the progression of symptoms.MethodWe reviewed the literature and selected risk factors, symptoms, and phenotypic traits of the women affected by endometriosis to create the questionnaire divided into 8 modules, with 47 questions. A total of 151 women completed the questionnaires: 51 patients who have endometriosis (the cases) and 100 matched women without endometriosis (the controls). After data collection, bivariate and multivariate analyses were conducted.ResultsWe retained four of the significant variables from a step-down logistic regression, namely chronic pelvic pain, dyspareunia with VAS≥3, painful defecation, and acne, to develop a final “predictive” logistic model achieving 90.2% sensitivity and 75% specificity.ConclusionOur pilot study demonstrated that the questionnaire provides a powerful tool for the secondary prevention of endometriosis.
Highlights
Endometriosis is an estrogen-dependent, chronic gynecological disease characterized by the presence of endometrial glands and stroma outside the uterus, which can result in a broad spectrum of symptoms, including dysmenorrhea, pelvic pain and infertility [1]
The data provided by the Italian Agency for Medicinal Products report that in Italy the prevalence of endometriosis in asymptomatic women varies from 2% to 22%, depending on the diagnostic criteria used and the population studied: in women with severe dysmenorrhea and chronic pelvic pain the percentage ranges from 40 to 60% and in women with subfertility it sets around 20% and 30% [6]
Amongst the various questionnaires reported in the literature that investigated different aspects of endometriosis, none had secondary prevention as their primary objective [39,46,47,48]
Summary
Endometriosis is an estrogen-dependent, chronic gynecological disease characterized by the presence of endometrial glands and stroma outside the uterus, which can result in a broad spectrum of symptoms, including dysmenorrhea, pelvic pain and infertility [1]. The etiopathogenesis of endometriosis is uncertain but is probably a multifactorial process resulting in a heterogeneous disease [2,3]. Women affected by this pathology have suffered for years from chronic pelvic pain, as well as from pain during the menstrual cycle and sexual intercourse [4,5]. Late clinical trials on gonadotropin-releasing hormone antagonists (GnRH-ant) showed the most promising results for the treatment of endometriosis [7]. The purpose of this study is to assess the reliability and validity of the questionnaire, as a tool to precociously identify women with endometriosis, to prevent the progression of symptoms
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