Abstract
Background. To evaluate the relationship between the severity of dysmenorrhea and endometrioma. Methods. Descriptive study with prospective design. Two hundred and thirty-nine women with histologically proved endometriomas. The severity of dysmenorrhea was assessed prospectively with a 10-cm visual analog scale. Various indicators concerning the endometrioma and the extent of deep infiltrating endometriosis were recorded during surgery in 239 patients. Correlations were sought with a multiple regression logistic model. Results. According to univariate analysis, the following variables were related to more severe dysmenorrhea: subperitoneal infiltration (uterosacral ligament and rectal infiltration) and R-AFS score of implants. None of the specific characteristics of endometriomas were associated with severe dysmenorrhea. After multiple regression analysis, rectal infiltration and R-AFS score of implants were the only factors that remained related to dysmenorrhea severity. Conclusions. When there is an endometrioma, severe dysmenorrhea is not directly related with the characteristics specific to these ovarian cysts. The associated deep infiltrating endometriotic lesions and in particular rectal infiltration could explain these symptoms.