New Scoring System to Identify Bowel Endometriosis Syndrome

This is the first scoring system based directly on a patient's symptoms

Key Points

Highlights:

•  A new scoring system developed by Danish scientists could help better diagnose bowel endometriosis syndrome (BENS) and measure the effect of treatments on the syndrome.

Importance:

•  The scoring system could be used in everyday clinical practice and reduce the number of misdiagnosed cases.

What’s done here?

• The researchers analyzed the symptoms of a total of 525 women using questionnaires on pelvic pain, quality of life, and urinary, sexual and bowel function.

Key results:

• The six most important item of the questionnaire that the researchers selected to calculated the BENS score were pelvic pain, quality of life, and urinary, sexual and bowel function. 
• According to the women’s score researchers divided them into three groups: no BENS, minor BENS, and significant BENS.

Limitations of the study:

• The scoring system was developed from a single in Denmark. Therefore it could have a social, cultural, and demographic bias.
• The system should be validated in other languages to compare its reliability in other countries.

Lay Summary

Researchers in Denmark have developed a new scoring system to identify women with bowel endometriosis syndrome (BENS) and monitor the effect of treatments on the syndrome.

The scoring system that can be used in everyday clinical practice is the first endometriosis classification system based directly on the patient’s symptoms.

Women with bowel endometriosis usually experience multiple symptoms such as painful urination, urgency to urinate and defecate, irregular bleeding, menstrual pain, constipation, and diarrhea, that researchers collectively called BENS.

To develop a simple and reproducible scoring system to evaluate the severity of BENS, the team analyzed 525 women who were treated at two University hospitals in Denmark, under the leadership of Dr. U.S. Kesmodel at Herlev University Hospital in Copenhagen 

The researchers also aimed to identify which aspects of the syndrome has the most significant impact on the women’s health-related quality of life. (Health-related quality of life is defined  a person’s perceived physical and mental health over time.)

In order to do this, they used questionnaires on pelvic pain, quality of life, and urinary, sexual and bowel function. Then they analyzed the patients’ answers and calculated their BENS score.

The six essential items that were selected for the score were pelvic pain, use of painkillers, constipation due to the lack of the reflex of defecation, difficulty urinating, urgent need to defecate, and satisfaction with sexual life.

According to the women’s score BENS was divided into three: “no BENS” for a score between zero and eight, “minor BENS,” for a score between nine and 16, and “major BENS” for a score between 17 and 28. 

The scientists think that this scoring system can, not only help doctors correctly diagnose bowel endometriosis but also see how well a particular treatment is working on their patients. More research is needed to ensure that the scoring system is valid across clinics. 

The study results published in the scientific journal Human Reproduction.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/28854723