Questioning patients about their adolescent history can identify markers associated with deep infiltrating endometriosis

Fertil Steril. 2011 Mar 1;95(3):877-81. doi: 10.1016/j.fertnstert.2010.10.027. Epub 2010 Nov 11.

Abstract

Objective: To investigate whether the clinical history, particularly of the adolescence period, contains markers of deeply infiltrating endometriosis (DIE).

Design: Cross-sectional study.

Setting: Universitary tertiary referral center.

Patient(s): Two hundred twenty-nine patients operated on for endometriosis. Endometriotic lesions were histologically confirmed as non-DIE (superficial peritoneal endometriosis and/or ovarian endometriomas) (n = 131) or DIE (n = 98).

Intervention(s): Surgical excision of endometriotic lesions with pathological analysis of each specimens.

Main outcome measure(s): Epidemiological data, pelvic pain scores, family history of endometriosis, absenteeism from school during menstruation, oral contraceptive (OC) pill use.

Result(s): Patients with DIE had significantly more positive family history of endometriosis (odds ratio [OR] = 3.2; 95% confidence interval [CI]: 1.2-8.8) and more absenteeism from school during menstruation (OR = 1.7; 95% CI: 1-3). The OC pill use for treating severe primary dysmenorrhea was more frequent in patients with DIE (OR = 4.5; 95% CI: 1.9-10.4). Duration of OC pill use for severe primary dysmenorrhea was longer in patients with DIE (8.4 ± 4.7 years vs. 5.1 ± 3.8 years). There was a higher incidence of OC pill use for severe primary dysmenorrhea before 18 years of age in patients with DIE (OR = 4.2; 95% CI: 1.8-10.0).

Conclusion(s): The knowledge of adolescent period history can identify markers that are associated with DIE in patients undergoing surgery for endometriosis.

MeSH terms

  • Absenteeism
  • Adolescent
  • Adolescent Health Services*
  • Adult
  • Contraceptives, Oral / administration & dosage
  • Cross-Sectional Studies
  • Endometriosis / epidemiology*
  • Endometriosis / pathology*
  • Endometriosis / surgery
  • Family Health
  • Female
  • Humans
  • Medical History Taking / statistics & numerical data*
  • Menstruation Disturbances / epidemiology
  • Menstruation Disturbances / pathology
  • Menstruation Disturbances / surgery
  • Pelvic Pain / epidemiology
  • Pelvic Pain / pathology
  • Pelvic Pain / surgery
  • Risk Factors
  • Severity of Illness Index
  • Young Adult

Substances

  • Contraceptives, Oral