Is pelvic endometriosis always associated with chronic pain?
OBJECTIVE: To establish a relationship between pelvic pain and the stage and severity of pelvic endometriosis determined according to the revised American Fertility Society classification. STUDY DESIGN: Retrospective study of 618 cases diagnosed by laparoscopy as endometriosis at the Tohoku University Hospital from 1984 to 1991. RESULTS: Pelvic pain did not appropriately reflect the stage and severity of pelvic endometriosis in 40% of patients. Although the pain in some patients in stage IV showed some correlation with the stage and severity of the disease, others had either no symptoms or paradoxically complained of less pain than those patients with stage I or II endometriosis. CONCLUSIONS: With the present revised American Fertility Society classification of endometriosis we cannot evaluate the severity of pelvic pain.