Diagnostic delay in women with pain and endometriosis

Husby, Gunhild Kalleberg; Haugen, Ragnhild Skipnes; Moen, Mette Haase

doi:10.1034/j.1600-0412.2003.00168.x

Cited by 250 publications

(133 citation statements)

References 6 publications

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“…4 A definitive diagnosis of endometriosis can only be made at surgery, generally via laparoscopy, and there are well-recognised risks associated with this. 5,6 Moreover, studies report that between 21 7 and 46% 8 of women with chronic pelvic pain are found not to have any identified pathology at laparoscopy.…”

Section: Introductionmentioning

confidence: 99%

Can symptomatology help in the diagnosis of endometriosis? Findings from a national case–control study—Part 1

Ballard

Seaman

Vries

et al. 2008

BJOG

355

246

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Objective To determine the value of patient-reported symptoms in diagnosing endometriosis.Design A national case-control study.Setting Data from the UK General Practice Research Database for years 1992-2001.Sample A total of 5540 women aged 15-55 years, diagnosed with endometriosis, each matched to four controls without endometriosis.Methods Data were analysed to determine whether specific symptoms were highly indicative of endometriosis. Odds ratios for these symptoms were derived by conditional logistic regression analysis. . Women with endometriosis were also found to consult the doctor more frequently than the controls and were twice as likely to have time off work.Conclusions Specific symptoms and frequent medical consultation are associated with endometriosis and appear useful in the diagnosis. Endometriosis may coexist with or be misdiagnosed as pelvic inflammatory disease or IBS.

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Section: Introductionmentioning

confidence: 99%

Can symptomatology help in the diagnosis of endometriosis? Findings from a national case–control study—Part 1

Ballard

Seaman

Vries

et al. 2008

BJOG

355

246

View full text Add to dashboard Cite

show abstract

“…Az első tünetek jelentkezésétől számítva Németországban és Ausztriá-ban például átlagosan 10 év [15], Norvégiában 6 év [16], míg Magyarországon 3,9 év telik el [17]. Pedig a korai diagnózis fontos volna, mivel a gyakran igen súlyos panaszokat okozó mélyen infiltráló endometriosis kedvezőtlenül befolyásolja a betegek életminőségét, növeli az egészségügyi kiadásokat és a csökkent munkaképesség miatt jelentős gazdasági kihatása is van [18].…”

Section: Megbeszélésunclassified

Prospektív vizsgálat a sigmoideoscopia diagnosztikai érzékenységének meghatározására vastagbelet infiltráló endometriosisban

et al. 2017

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Bevezetés és célkitűzés:A colorectalis rendszert érintő endometriosis ellátása multidiszciplináris laparoszkópos teammel javasolt. A bélinfiltráció preoperatív felismerése ehhez elengedhetetlen. Betegek és módszer: 2009-2015 között prospektíven 383, endometriosissal diagnosztizált betegnél történt sigmoideoscopia. Intraluminalis endometriosis, fali infiltrációra jellemző másodlagos jelek (falmerevség, benyomat, megtöretés, vizsgálat alatti fájdalom, suffusio) kerül-tek feldolgozásra. Műtéti indikáció esetén a pozitív esetek multidiszciplináris, a negatív esetek nőgyógyász által vég-zett műtéten estek át. Eredmények: 224 (58,49%) pozitívnak talált beteg közül 108-nál multidiszciplináris műtét történt, a negatívnak bizonyult esetek közül 135 ginekológiai műtéten esett át. 108-ból 103 betegnél a műtét során is igazolódott a bél érintettsége, míg a negatív esetek közül nyolc esetben volt jelentős bélinfiltráció. Teljes sigmoideoscopiás vizsgálat 43,4%-ban volt kivitelezhető. Intraluminalis endometriosis 4,91%-ban, fali merevség 38,39%-ban, benyomat 45,54%-ban, megtöretés 57,14%-ban, fájdalom (narkózis nélkül végzett vizsgálatoknál) 26,06%-ban, suffusio 3,82%-ban fordult elő. A sigmoideoscopia szenzitivitása: 92,8%, specificitása: 96,2% volt. Következtetés: A sigmoideoscopia -tapasztalt endoszkópos esetében -kiemelkedő szenzitivitású eszköz a belet infiltráló endometriosis igazolásában. Orv. Hetil., 2017, 158(7), 264-269.Kulcsszavak: sigmoideoscopia, mélyen infiltráló endometriosis, bélinfiltráció, sebészet Prospective study to determine the diagnostic sensitivity of sigmoidoscopy in bowel endometriosis Introduction and aim: In the treatment of colorectal endometriosis a multidisciplinary laparoscopic resection is suggested, for this reason the correct selection of bowel infiltration is essential before surgery. Patients and method: Between 2009 and 2015, 383 sigmoidoscopies were performed in patients with endometriosis. Where mucosal invasion was absent secondary signs (wall rigidity, impression, kinking, pain during the examination, suffusion) were analysed. In endoscopically confirmed cases multidisciplinary surgery was performed, the remaining patients were operated by a gynecologic team only. Results: Endometriosis was endoscopically confirmed in 224 patients (58.49%), 108 of them underwent multidisciplinary operation, the negative 135 cases received gynaecological surgery. Bowel endometriosis was confirmed in 103 out of 108 cases intraoperatively, while in 8 cases of the sigmoidoscopically negative patients bowel infiltration was diagnosed intraoperatively by the gynaecological team. Complete sigmoidoscopy was performed in 43.47% of the cases. Intraluminal endometriosis was found in 4.91%, secondary signs as rigidity in 38.39%, impression in 45.54%, kinking in 57.14%, pain (in cases of examination without narcosis) in 26.06% and suffusion in 3.82% of the cases was found during sigmoidoscopy. Sigmoidoscopic examination has a 92.8% specificity and 96.2% sensitivity in cases of bowel endometriosis. Conclusion: Sig...

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“…Longer delays can occur when the symptoms begin in adolescence. 3,4 Aside from the variability in presentation, the major reasons for delays in diagnosis include the prevalence of pelvic pain symptoms in the community and a lack of awareness by many health professionals that the onset of symptoms often occurs in adolescence. However, it is widely recognised around the world that endometriosis is now the commonest cause of chronic pelvic pain in women in most industrialised societies.…”

Section: Assessing Women With Suspected Endometriosismentioning

confidence: 99%

“…Medical treatments for endometriosis usually improve fertility. 4. Danazol is one of the first-line treatments of choice for endometriosis.…”

Section: Referencesmentioning

confidence: 99%

Medical management of endometriosis

Black¹,

Fraser²

2012

Aust Prescr

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Diagnostic delay in women with pain and endometriosis

Abstract: In Norway there is a considerable delay in the diagnosis of endometriosis, with figures comparable to results from Anglo-American studies. A greater awareness of symptoms of endometriosis and a more rapid investigation should thus be encouraged.

Cited by 250 publications

References 6 publications

Can symptomatology help in the diagnosis of endometriosis? Findings from a national case–control study—Part 1

Can symptomatology help in the diagnosis of endometriosis? Findings from a national case–control study—Part 1

Prospektív vizsgálat a sigmoideoscopia diagnosztikai érzékenységének meghatározására vastagbelet infiltráló endometriosisban

Medical management of endometriosis

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