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.