Pain in endometriosis correlates with :
Correct Answer: Depth
Description: Ans. is a i.e. Depth invasion -Deep penetrating endometriosis is a form of the disease which was described by Koninck's group. These lesion can extend 1 Omm or more down from the peritoneal surface and the deeper lesions appear to have a closer associations with pain than infeility, whereas less deep lesions have a closer association with infeility than pain." Dysmenorehea : ... Williams Gyane. 1/e, p 230 "Cyclical pain with menstruation is noted commonly in women with endometriosis. Typically. endometriosis associated dysmenorrhea preceedes menses by 24 to 48 hours and is less responsive to NSAID and combination oral contraceptives. This pain is thought to be more severe in comparison with primary dysmenorrhea and Crammer and associates demonstrated a positive correlation between the severity of dysmenorrhea and the risk of endometriosis. Fuhermore, deeply infiltrating endometriosis, that is disease that extends > 5 mm under the peritoneal surface, also appears to have positive correlation to the severity of dysmenorrhea." From above lines it is clear that pain in endometriosis coincides with the depth of lesion. As far as other options are concerned ? "The levels of CA 125 correlate with severity of the disease, but since there is a wide variety of conditions in which the levels are elevated. lts greatest use may be in monitoring a patient serially for recurrence." (ruling out "option c") "Most studies have failed to detect a correlation between the degree of pelvic pain and severity of endometriosis. Some women with extensive disease have no pain, whereas others with only minimal disease may experience severe pelvic pain and dyspareunia may be associated with infiltrating sub peritoneal endometriosis." (ruling out option "d").
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Gynaecology & Obstetrics
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