Influence of Endometriosis Pain on Quality of Life: Assessing Specific Pain Scales from Both Short Form 36 and Endometriosis Health Profile 30

Abstract

To assess the correlation between intensity of the major painful symptoms of deep infiltrating endometriosis (DIE) with pain scales from both Short Form 36 (SF36) and Endometriosis Health Profile 30 (EHP30). Sectional observational study. Public teaching hospital. Women with DIE diagnosed by nuclear magnetic resonance (n = 65; ages 20 to 53y). Exclusion criteria: incapability to answer the questionnaires, self-reported symptomatic pathologies/traumas or refuse. Anamnesis and patient self-reported scores from SF36 (bodily pain) and EHP30 (pain) quality of life (QoL) questionnaires. From July 2010 to March 2012, in parallel to preoperative evaluation for cytoreductive laparoscopy, patients answered Brazilian validated versions of both questionnaires to estimate different domains of QoL; scales were standardized from 0 (worst) to 100 (best QoL). Besides, endometriosis pain intensity was quantified by an analog scale (0-10). Median scores and percentiles 5 and 95 for major symptoms were: dyspareunia (4.0; 0.0-10.0), dysmenorrhea (8.0;0.0-10.0), hypogastric pain (3.4;0.0-10.0), dyschezia (0.0;0.0-7.0) and menstrual dyschezia (0.4;0.0-10.0). Analysis was performed with SPSS 15.0 for Windows; significant if P<0.05. Shapiro-Wilk test showed non-normal distribution of QoL scales. Nonparametric correlation was expressed with Spearman coefficient and p value. As expected, there was significant correlation between EHP30 and SF36 pain scores (0.378; 0.001), dyspareunia (-0.437; <0.001), dysmenorrhea (-0.389; 0.001), hypogastric pain (-0.437; <0.001) and menstrual dyschezia (-0.260; 0.035); while correlation with dyschezia was close to significance (-0.226; 0.070). On the other hand, despite significant negative correlation with dyspareunia (-0.373; 0.002) and hypogastric pain (-0.418; <0.001), SF36 bodily pain scores showed no significant correlation with dysmenorrhea (-0.128; 0.311), dyschezia (-0.180; 0.151) and menstrual dyschezia (-0.193; 0.121). Data suggest that a specific tool (EHP30) should be preferred to assess the influence of endometriosis pain on QoL because SF36 bodily pain scale showed no significant correlation with dysmenorrhea (one of the most important painful symptom in endometriosis).