Conclusion
Our study showed that an increase in pain symptoms does not necessarily lead to an increase in DE involvement. The symptom dyschezia has some predictive value for ureteric involvement, and therefore patients with dyschezia should preferably get an MRI of the pelvis or an ultrasound scan of the kidneys/ureters for an optimal surgical workup. Already minor dysuria symptoms can indicate the presence of endometriosis in the bladder. More and more evidence is showing that pain symptoms in deep endometriosis have a multifactorial cause, which partly explains the poor correlations in studies focussing solely on anatomical locations and pain symptoms.