OC12.06: *Correlation between pelvic pain symptoms and the presence of deep or ovarian endometriosis: a prospective ultrasound study

To assess whether women with deep or ovarian endometriosis are more likely to experience pelvic pain symptoms and a lower quality of life (QOL) compared to women without this condition. This was a prospective observational cohort study conducted between February 2019 and October 2020. All premenopausal, non-pregnant women aged 18–50 years, consecutively scanned by a single experienced examiner were eligible for inclusion. Participants completed the BSGE pelvic pain questionnaire. Endometriosis was identified using transvaginal ultrasound. The primary outcome was presence of moderate to severe levels of pelvic pain symptoms (score of ≥4 on 11-point numerical rating scale). The secondary outcome was QOL, which was measured by EQ-5D-3L. The number of women with pain scores ≥4 and median QOL scores were compared between groups with and without endometriosis. Demographic and clinical factors were adjusted for on multivariable analysis. The final study sample was comprised of 514 women, 146 (28.4%) of whom were diagnosed with endometriosis. After multivariable analysis, only menstrual dyschezia [OR 2.44 (1.59–3.78), P<0.001) and difficulty emptying bladder [OR 2.56 (1.52–4.31), P<0.001) occurred significantly more frequently in women with endometriosis than those without. There was a trend towards menstrual pain [OR 1.72 (0.92–3.20), P = 0.09) and lower EQ-5D scores [0.79 (0.69–0.85) vs 0.80 (0.69–0.88), P = 0.06] being more common in women with endometriosis. The occurrence of most pelvic pain symptoms was comparable between the groups with and without endometriosis, indicating that endometriosis may not always be the source of pain, even if present. This emphasises the importance of investigating other causes of pain in symptomatic patients, before embarking upon high-risk procedures, and providing appropriate patient counselling.