Relationship of pelvic clinic-pathological features and the pain symptoms in ovarian endometrioma 【Key word】 Endometriosis; Pain; Pelvis; Laparoscopy

Objectiv e To study the relationship between the clinic-pathological features and pain symptoms in patients with endometriotic cyst (EM). Methods The medical data of symptoms,laparoscopy and pathology examination in 416 patients with endometriosis were studied retrospectively.All cases were divided into two groups on the existence of ovarian endometrioma,including 338 patients in cyst group and 78 cases in non-cyst group.The relationship between clinical symptoms and location and type of endometrioma was studied. Results (1) Serum CA125level:the level of CA125were (61±39) k U/L in cyst group (28±24) k U/L in non-cyst group,which reached statistical difference (P 0.05),and the incidence of chronic pelvic pain (CPP) of 24.6% (83/338) and dyspareunia of 29.9% (101/338) in the cyst group were significantly lower than 35.9% (28/78) and 44.9% (35/78) in non-cyst group (P<0.05).The incidence of dysmenorrheal was 85.1% (114/134) in cases with bilateral cyst,which was higher than 74.0% (151/204) in cases with single cyst.The incidence of dysmenorrheal and dyschezia in moderate-severe adhesion was 89.0% (138/155) and 18.7% (29/155),which was significantly higher than 68.8% (126/183) and 8.2% (15/183) in mild adhesion.In the patients cyst existed with DIE,the risk of dysmenorrheal,CPP,dyspareunia,and dyschezia were obviously raised (ORrespectively was 5.17,3.01,3.05,2.75). Conclusions The endometriotic cyst often co-exists with other type of endometriotic lesions.Ovarian endometrioma was associated with lesion localized on uterine surface,cul-de-sac,sacrum ligament.The risk of all the pain symptoms would be raised when the endometriotic cyst coexit with the DIE lesions.So the treatment for DIE lesions was as same important as the endometriotic lesions in order to relieve pain symptoms and delay the relapse.