Correlation Between Pain Intensity in Different Locations and Intraoperative Stage of Endometriosis According to rASRM and #ENZIAN Classification.
Level 4 - case-series / case-control
Observational cross-sectional study evaluating correlation between symptom scores and surgical staging systems
PubMed 41977023 · doi:10.3390/jcm15072725
What was done
Pain intensity across four domains (pelvic pain, dyschezia, dysuria, and dyspareunia) was measured using a 10-point Numerical Rating Scale (NRS) in 138 patients with advanced endometriosis undergoing surgical treatment between May 2024 and August 2025. Intraoperative disease stage was classified according to the rASRM and #ENZIAN systems. Non-parametric statistical tests and Spearman's rank correlation coefficient were applied.
What was found
No significant correlation was identified between overall pelvic pain intensity and rASRM disease stage. A statistically significant difference across rASRM stages was observed for pain during micturition (p = 0.004). In #ENZIAN-based analyses, significant associations were detected between specific anatomical areas and pain during micturition, defecation, and sexual intercourse. Exact correlation coefficients, score distributions, and effect sizes were not provided in the abstract.
Why it matters
Global staging under rASRM fails to reflect overall pain severity, whereas the compartment-based #ENZIAN system aligns better with organ-specific pain symptoms in patients requiring surgery.
Limits
The study is restricted to a single surgical cohort of patients with advanced endometriosis and cannot be generalized to milder or non-surgically managed disease. The abstract omits exact correlation coefficients, point estimates, confidence intervals, and potential confounders such as preoperative hormonal therapies.
Cited by
- supports The surgical or anatomical stage of endometriosis does not correlate with the severity of pelvic pain experienced by the patient.