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Is endometriosis staging related to the type and intensity of patients' complaints?

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dc.contributor.authorAlves, João Sequeira
dc.contributor.authorMeneses, Tânia
dc.contributor.authorMariano, Mafalda
dc.contributor.authorSilvério Serra, Sofia
dc.contributor.authorCosta, Teresa
dc.contributor.authorMartins, João Paulo
dc.contributor.authorRabishong, Benoit
dc.contributor.authorLima, Jorge
dc.contributor.institutionNOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)
dc.contributor.institutionComprehensive Health Research Centre (CHRC) - pólo NMS
dc.contributor.pblElsevier
dc.date.accessioned2026-01-14T15:54:18Z
dc.date.available2026-01-14T15:54:18Z
dc.date.issued2026
dc.descriptionCopyright © 2025. Published by Elsevier Inc.
dc.description.abstractOBJECTIVE: To evaluate the association between the endometriosis staging and the type and intensity of pain reported by patients, describing the pain intensity across different pain types. DATA SOURCES: On January 27, 2025, a systematic search was conducted in PubMed, Scopus, Web of Science, EMBASE, and the Cochrane Library. The search terms included endometriosis, pain, dysmenorrhea, dyspareunia, pelvic pain, dyschezia, dysuria, and classification. METHODS OF STUDY SELECTION: Eligible studies examined women with endometriosis, assessing how endometriosis staging (rASRM or ENZIAN classification) correlated with pain symptoms (dysmenorrhea, dyspareunia, dyschezia, dysuria, and chronic pelvic pain) measured with validated tools. TABULATION, INTEGRATION, AND RESULTS: Two reviewers extracted data independently, with a third verifying results. Pain scores were log-transformed to stabilize variance, and proportions of women with advanced endometriosis were analyzed on the logit scale. Given high heterogeneity, random-effects models with restricted maximum likelihood were used. Of 2,527 records, 112 studies were reviewed and eight met inclusion criteria (seven using rASRM, one using ENZIAN). Dysmenorrhea showed the highest mean intensity (6.61, 95%CI: 4.43-10.10), while dysuria was lowest (1.08, 95%CI: 0.62-1.89). Pain intensity did not differ significantly between rASRM stages I/II and III/IV (p > 0.05), though chronic pelvic pain was more frequent in advanced disease (p < 0.05). CONCLUSION: Dysmenorrhea is linked to higher pain intensity in women with endometriosis, while dysuria is linked to lower intensity. Pain intensity is not associated with the rASRM stage; however, chronic pelvic pain seems more prevalent in advanced stages of the disease.en
dc.description.versionproof
dc.description.versionpublished
dc.format.extent913533
dc.identifier.doi10.1016/j.jmig.2025.11.014
dc.identifier.issn1553-4650
dc.identifier.otherPURE: 148527122
dc.identifier.otherPURE UUID: 196abdc6-ec16-4c6d-997d-cebd9a1f79ae
dc.identifier.otherPubMed: 41338448
dc.identifier.otherScopus: 105029040980
dc.identifier.urihttp://hdl.handle.net/10362/199041
dc.language.isoeng
dc.peerreviewedyes
dc.subjectendometriosis
dc.subjectdysmenorrhea
dc.subjectchronic pelvic pain
dc.subjectASRM
dc.subjectENZIAN
dc.titleIs endometriosis staging related to the type and intensity of patients' complaints?en
dc.title.subtitleA systematic review and meta-analysisen
dc.typereview
degois.publication.titleJournal of minimally invasive gynecology
dspace.entity.typePublication
rcaap.rightsopenAccess

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