Questioning patients about their adolescent history can identify markers associated with deep infiltrating
Charles Chapron1, Marie-Christine Lafay-Pillet, Elise Monceau
1Faculté de Médecine, Université Paris Descartes, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Universitaire Ouest, Centre Hospitalier, Paris, France. charles.chapron@cch.aphp.fr
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.
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