Design: A retrospective study.

Setting: Endometriosis clinic of a tertiary medical center.

Patients or Participants: women aged 18-54 with surgically proven superficial endometriosis with no deep lesions or ovarian involvement. The control groups included women with imaging-proven deep infiltrating endometriosis and ovarian endometriosis.

Interventions: Demographic data (age, BMI, Parity), different Pain symptoms
(dysmenorrhea, dyspareunia, dysuria, dyschezia, chronic pelvic pain, chronic
fatigue abdominal bloating, lower back pain) and GI symptoms were
compared between women with surgically proven endometriosis and women
with deep and ovarian endometriosis.

Measurements and Main Results:

A total of 248 women participated in the study. Among them, 32.3%
(n=80) had surgically proven superficial endometriosis, and 67.8% (n=168)
had deep infiltrating endometriosis or ovarian endometriosis, diagnosed by
surgery or imaging. Women with superficial endometriosis were younger as
compared to women with deep or ovarian endometriosis (31.9±6.8 vs
37.3±6.8 years, p=0.001, respectively). Dyschezia, dyspareunia and chronic
pelvic pain (CPP) were significantly more common among women with deep
and ovarian endometriosis (dyschezia: 77.2% vs 53%, P=0.02; dyspareunia:
54.8% vs 18.8,% p=0.001; and CPP: 51.5% vs 16.2%, p=0.001).
Severe dysmenorrhea (81% vs 45.8%, p=0.001), dysuria (30% vs 11.9%, p=
0.002) and IBS symptoms (31.2% vs 13.7%, p=0.01) were significantly more
common in the superficial endometriosis group.

Conclusion: In our cohort, whereas dysmenorrhea was more common
among women with superficial endometriosis, other pain symptoms were
significantly more common among women with non-superficial endometriosis.
Better understanding of clinical presentation may improve diagnostic
accuracy.