Is there a relationship between symptoms and types of endometriosis according to #ENZIAN? A comparative study of preoperative questionnaires.

Objective: The primary objective was to evaluate the relationship between these three groups and digestive symptoms. The secondary objective was to evaluate all symptoms in all groups.

Study design: It was a retrospective comparative analysis of preoperative questionnaires. Three groups of patients were compared: Group 1 Patients with only peritoneal endometriosis ± adnexal adhesions and adenomyosis (P ± T and FA), Group 2 Patients with DIE, excluding the digestive system, and/or cystic ± peritoneal and adnexal adhesions and adenomyosis (O, A, B ± P, T, and FA), Group 3 Patients with DIE of the digestive system (C, FI) ± other localizations.

Results: This retrospective study of 233 preoperative questionnaires explored symptom profiles across #ENZIAN-classified endometriosis types. No overall symptom differences were found, but severe dyschezia (VAS ≥ 5) correlated with bowel involvement (C compartment), dyspareunia corelated with adenomyosis (FA compartment), and chronic pelvic pain was lower in bowel DIE (Group 3) than in peritoneal/ovarian groups. Symptom questionnaires may guide surgical referral despite imaging limitations.

Conclusion: While these imaging modalities can help identify DIE and endometriomas, they are less effective in detecting superficial peritoneal lesions, which can also cause significant symptoms. For this reason, even though symptom questionnaires are not definitive diagnostic tools, they may serve as an important starting point for further investigation and referral for surgical evaluation.