CHANGING TRENDS IN THE DIAGNOSIS OF ENDOMETRIOSIS - A COMPARATIVE-STUDY OF WOMEN WITH PELVIC ENDOMETRIOSIS PRESENTING WITH CHRONIC PELVIC PAIN OR INFERTILITY

Objective: To compare demographic, epidemiologic, and medical data and to evaluate diagnostic trends in women with endometriosis and chronic pelvic pain symptoms or endometriosis and infertility. Design: Retros pective analysis. Setting: Institute for the Study and Treatment of En dometriosis. Patient(s): Six hundred ninety-three consecutive patients with endometriosis and chronic pelvic pain (n = 357) or endometriosis and infertility (n = 336). Intervention(s): None. Main Outcome Measur e(s): Demographic and epidemiologic parameters, diagnostic trends. Res ult(s): Women with pelvic symptoms were younger, had less formal educa tion, more frequent family history, and higher frequency and intensity of pelvic complaints. Mean ages at first symptom and diagnosis were l ower in the pain group, but stage of endometriosis at first diagnosis was more advanced. The mean ''diagnostic delay'' was longer in the pel vic pain than in the infertile group (6.35 versus 3.13 years), but it decreased during three consecutive 5-year intervals in both groups, an d there was also a gradual decrease in the frequency of advanced endom etriosis at; the time of first diagnosis. Conclusion(s): Demographic a nd epidemiologic parameters in women with endometriosis differ, depend ing whether chronic pelvic pain or infertility are the presenting symp toms. In the pain group, diagnostic delay is longer and endometriosis at diagnostic laparoscopy more advanced, indicating progressiveness of the disease. During the last 15 years, diagnostic delay steadily of c lined.