Page 29 - Diagnostic delay of endometriosis

telephonic contact. Consent was obtained from all women included in the analysis.
Results
Ninety three patients of the 139 that were selected completed the full questionnaire. One patient was excluded because of a language barrier. Five women did not give consent to participate in the study. Of these, 2 women preferred not to participate because of the emotional stress associated, 2 women did not give permission to review their record, and 1 woman refrained because she was discontented with the working of the hospital. Forty women were not reached by phone after at least 4 attempts.
The median age at onset of symptoms was 20 (range 14–29) and median age at diagnosis was 31 (range 28–34). Women consulted their GP because of various complaints. The most frequent complaint was dysmenorrhea (n = 51). Besides dysmenorrhea, continuous abdominal pain (n = 9), subfertility (n = 6), dyspareunia (n = 1), atypical gynaecologic complaints like menorrhagia (n = 10) and atypical non-gynaecologic complaints like dysuria and syncope (n = 16) were mentioned.
The median total diagnostic delay was 89 months (interquartile range 25–169), that is, 7.4 years. The median patient delay was 7 months, GP delay was 35 months and gynaecologist delay was 5 months. Diagnostic delay was shorter for patients who consulted their GP because of subfertility as compared to patients with pain-related reasons for seeking medical help (median delay of 21 vs. 100 months, p = 0.024).
An extended period of time from first GP visit to referral to a gynaecologist was significantly associated with young age at developing symptoms (p < 0.001). Considering one or more other diagnoses before endometriosis, cyclic symptoms, use of oral contraceptives because of dysmenorrhea, and use of analgesics were significantly correlated with extended time from GP presentation to referral to a gynaecologist. This sub-analysis additionally shows an extended time from GP to referral when symptoms were considered common menstrual pains (p <0.001) or were falsely attributed to irritable bowel syndrome (p = 0.014) or somatisation (p = 0.021). A longer patient delay was associated with a longer GP delay (4 vs. 12 months, p = 0.028). Type of endometriosis did not relate to the time from first GP contact until
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