Endometriosis and pelvic pain

Endometriosis is a chronic, benign, gynecological disorder characterized by the presence of ectopic endometrial tissue outside the uterine cavity, affecting up to 10% of women of reproductive age. Endometriosis is a complex and heterogeneous disease, whose symptoms are widely variable and sometimes unrelated to the site or to the stage of the disease 2. Some patients are asymptomatic, while others report severe painful symptoms, such as chronic pelvic pain (CPP), dysmenorrhea, dyspareunia, dyschezia or dysuria, compromising the health status and the quality of life (QoL) . It represents the first cause of school absenteeism and seems to involve up to 60% of adolescents with pelvic pain. In 30%-40% of cases, endometriosis is associated with infertility . At present, surgery remains the gold standard for the endometriosis’s diagnosis and treatment, but it is burdened by the inherent risks of surgical morbidity and potential decrease in ovarian reserve. Non-invasive diagnostic methods, such as transvaginal sonography (TVUS) and magnetic resonance imaging (MRI), identify and characterize endometriotic lesions with a high accuracy and help in the management decision making. Several medical treatments have been suggested to control pain, delay surgery, prevent recurrences and preserve fertility; the medical approach is hugely accepted and proves to be effective and safe.