Importance of classification despite poor clinical correlation
Despite the limited correlations, anatomical based endometriosis
classification remains important. Classification provides a uniform
language to communicate, monitor and report the disease (26). This
enables standardisation of outcome measures and provides a universal way
to communicate about endometriosis in clinical and research settings.
Our study differs from other clinical correlation studies on DE, because
we analysed solitary anatomical structures classified with Enzian
(compartment A, B and C) related to preoperative pain symptoms as well
combinations of compartments (AB, AC, BC, ABC). The results of our study
shows that an increase in pain does not correlate with the extent of
anatomical involvement. This means that an increase in endometriosis
involvement, does not automatically lead to an increase in pain
symptoms. This knowledge is new and provides insight in the pain
behaviour/symptoms of DE patients. Therefore, clinicians cannot rely on
the clinical presentation of DE patients in relation to the disease
extent and equally, doctors cannot give information pre-operatively on
the severity of the disease.