Symptoms based on location of endometriosis lesions:
- Foti, P. V., Farina, R., Palmucci, S., Vizzini, I. A. A., Libertini, N., Coronella, M., … & Milone, P. (2018). Endometriosis: clinical features, MR imaging findings and pathologic correlation. Insights into imaging, 9(2), 149-172.
“Clinical manifestations depend on the anatomic locations of the disease.
- Bladder: dysuria, gross hematuria during menses, irritative voiding symptoms, urgency, frequent urination, urinary storage symptoms, tenesmus, burning sensation, suprapubic discomfort and pain, urinary incontinence [2, 3, 15].
- Ureters: dysmenorrhea, dyspareunia, urinary symptoms, hydronephrosis, flank pain, decline of renal function [2, 3].
- Round ligaments: painful, palpable inguinal mass (extra-pelvic portion of the ligaments); nonspecific pelvic pain (intra-pelvic portion) .
- Retrocervical region and uterosacral ligaments: severe and painful symptoms, dyspareunia .
- Vagina: dysmenorrhea, dyspareunia, postcoital spotting, prolonged menstruation not responding to medical therapy leading to anaemia [3, 16].
- Rectosigmoid colon: cyclic pain during defecation, dyschezia, cyclic hematochezia, bloating, constipation, bowel cramping, catamenial diarrhoea, pencil-like stools, bowel obstruction [2, 3, 12, 17].
- When unusual locations outside the pelvis occur, the pain may be site specific.
- Thoracic-diaphragmatic endometriosis: chest pain (diffuse or basithoracic) with right-sided predominance, scapular or cervical pain associated with menses, sometimes radiating to the arm, pneumothorax, dyspnea, hemoptysis [18,19,20].
- Sciatic nerve: cyclic sciatica, back pain, gluteal pain radiating to the dorsal thigh and lateral lower leg, positive Lasègue’s sign, sensory loss, reflex alterations, muscle weakness, paresis [2, 21,22,23].”