97. Pain Interference in Adolescents and Adults with Chronic Pelvic Pain Due to Endometriosis

Background Endometriosis is the leading cause of chronic pelvic pain (CPP) among adolescents. However, little is known about how pain interference (PI), the degree to which pain interferes with functional domains and physical, emotional, and recreational activities, may impact adolescents with CPP due to endometriosis. This study aims to examine how PI experiences may differ between adolescent and adult patients with CPP due to endometriosis. Methods Adolescents (n = 17, age ≤21) and adults (n=32) assigned female at birth (AFAB) with surgically confirmed endometriosis and CPP (characterized by pain ≥3/10, ≥14 days per month) despite hormonal medication use, were recruited for a 6-month drug trial. One participant from the original study cohort (n = 50) was excluded from analyses due to unrelated congenital physical disability affecting physical ability measures. At baseline, participants completed a modified Functional Disability Inventory (FDI), a measure of daily functioning related to disease; Brief Pain Inventory (BPI) Interference Scale, a pain-specific measure of daily functioning; and a modified Biberoglu and Behrmen (B&B) patient rating scale, a pain measure often used in endometriosis-specific research. Both univariate and multivariate regression models were developed in analyses, and included adjustments for patient BMI, percent of lifetime with endometriosis (measure of time since endometriosis diagnosis relative to age), and/or diagnosis of mood disorder. The study was approved by the institutional IRB. Results Participants were predominantly white (95.9%), non-Hispanic (95.9%), and non-smokers (93.9 %) (Table 1). Of those with endometriosis staging available (information missing for 35.3% adolescents and 65.6% adults), most were stage 1 (52.9% and 21.8%, respectively) or stage 2 (5.9% and 6.3%). Adolescents had statistically higher PI scores (β = 1.61 CI: [0.30, 2.92], p = 0.02), and higher FDI scores (β = 7.70 CI: [1.13, 14.29], p = 0.02) than adults (Table 2). The median FDI adult score (11.5) was within the “no/minimal disability” range (0-12), while the median adolescent score (27.0) was in the “moderate disability” range (13-29). No statistical difference in the B&B pelvic pain scale was identified between groups (p = 0.49). Conclusions We found that adolescents with CPP due to endometriosis experience higher PI and functional disability attributes than adults with the same condition. Adolescents may have more challenges with daily functioning like moving around, sleep, participation in school/work, and relationships. Based upon these results, clinicians should carefully screen adolescents with CPP for functional disability.