Endometriosis lesion distribution by age at presentation: an international multicentre database study

Area of Science:

• Gynecology
• Surgical Pathology
• Epidemiology

Background:

• The natural history and causes of endometriosis are not fully understood, with varying evidence on disease progression, spontaneous regression, and stability.
• Existing research presents conflicting data regarding the evolution of endometriosis with patient age.

Purpose of the Study:

• To investigate how the frequency and anatomical location of endometriosis lesions change with patient age.
• To analyze the relationship between patient age and the prevalence of different types of endometriosis lesions observed during laparoscopy.

Main Methods:

• A cross-sectional analysis was conducted using data from a prospectively collected surgical registry.
• Data from 14,670 cases across 104 accredited endometriosis centers in 7 countries, spanning ages 10-55 from 2009-2021, were analyzed.
• Logistic regression models were used to assess the association between age and lesion prevalence, adjusting for prior endometriosis surgery.

Main Results:

• Superficial endometriosis prevalence decreased linearly with age (3% per year).
• Prevalence of bowel, deep sidewall, and uterosacral endometriosis increased with age until the early 30s, with deep bladder disease peaking around age 28.
• Ovarian endometrioma prevalence increased until age 40.9, while the total number of affected sites increased until age 32.8.

Conclusions:

• Older patients tend to have more deep-seated endometriosis lesions and ovarian endometriomas compared to younger patients.
• The prevalence of superficial endometriosis decreases with advancing age.
• Findings suggest age-related patterns in the distribution and type of endometriosis lesions.