Prevalence of endometriosis in diagnostic and therapeutic laparoscopy among women with chronic pelvic pain
Siivonen, Saima (2023-11-19)
Prevalence of endometriosis in diagnostic and therapeutic laparoscopy among women with chronic pelvic pain
(19.11.2023)
Julkaisu on tekijänoikeussäännösten alainen. Teosta voi lukea ja tulostaa henkilökohtaista käyttöä varten. Käyttö kaupallisiin tarkoituksiin on kielletty.
suljettu
Julkaisun pysyvä osoite on:
https://urn.fi/URN:NBN:fi-fe20231122148402
https://urn.fi/URN:NBN:fi-fe20231122148402
Tiivistelmä
Background: Diagnostic and therapeutic laparoscopy is indicated, when endometriosis is suspected after failed or unsuitable empirical medical therapy in women with severe pelvic pain and no imaging findings.
Aims: Our objective was to determine how often endometriosis is verified in laparoscopy when suspected.
Methods: In our registry-based retrospective study we identified 296 women aged 15-49 undergoing laparoscopy due to pain symptoms suggestive of endometriosis between years 2009-2020 in Turku University Hospital endometriosis center. Women without preoperative ultrasound findings were included in the study. We collected preoperative characteristics and intraoperative findings from the hospital patient records.
Results: Macroscopic endometriosis was detected in 52.4% of laparoscopies, and the rate was similar throughout the study period. Peritoneal endometriosis was found in 52% of participants, deep endometriosis in 4.7% and a small endometrioma in 2%. Women with and without endometriosis reported similar preoperative rates of acyclic abdominal pain (91.8% vs 93.9%, p=0.64) and dyspareunia (84.6% vs 78.9%, p=0.32), while dyschezia was significantly more common among women with endometriosis (44.4% vs 26.9%, p=0.006). The prevalence of dysmenorrhea is not reported, as 62.5% of patients used hormonal therapy commonly aiming to amenorrhea.
Conclusions: Endometriosis was confirmed in over half of the women undergoing laparoscopy due to chronic pelvic pain, and in most women, peritoneal endometriosis was the only finding. However, the other half of women did not have endometriosis despite having similar pain symptoms prior to surgery. It remains unknown if patients gain long-term benefit from undergoing diagnostic and therapeutic laparoscopy and treatment of superficial endometriosis.
Aims: Our objective was to determine how often endometriosis is verified in laparoscopy when suspected.
Methods: In our registry-based retrospective study we identified 296 women aged 15-49 undergoing laparoscopy due to pain symptoms suggestive of endometriosis between years 2009-2020 in Turku University Hospital endometriosis center. Women without preoperative ultrasound findings were included in the study. We collected preoperative characteristics and intraoperative findings from the hospital patient records.
Results: Macroscopic endometriosis was detected in 52.4% of laparoscopies, and the rate was similar throughout the study period. Peritoneal endometriosis was found in 52% of participants, deep endometriosis in 4.7% and a small endometrioma in 2%. Women with and without endometriosis reported similar preoperative rates of acyclic abdominal pain (91.8% vs 93.9%, p=0.64) and dyspareunia (84.6% vs 78.9%, p=0.32), while dyschezia was significantly more common among women with endometriosis (44.4% vs 26.9%, p=0.006). The prevalence of dysmenorrhea is not reported, as 62.5% of patients used hormonal therapy commonly aiming to amenorrhea.
Conclusions: Endometriosis was confirmed in over half of the women undergoing laparoscopy due to chronic pelvic pain, and in most women, peritoneal endometriosis was the only finding. However, the other half of women did not have endometriosis despite having similar pain symptoms prior to surgery. It remains unknown if patients gain long-term benefit from undergoing diagnostic and therapeutic laparoscopy and treatment of superficial endometriosis.