Korean J Obstet Gynecol.  2011 Aug;54(8):448-453. 10.5468/KJOG.2011.54.8.448.

Prognosis of endometriosis after surgical treatment in adolescents below 20 year age

• Sung NY
• Kim BS
• Cho YJ
• Choo YS
• Kim JM
• Yang SH

• KMID: 2274065
• DOI: http://doi.org/10.5468/KJOG.2011.54.8.448

Abstract

OBJECTIVE
To evaluate the clinical characteristics and prognosis of surgically treated endometriosis in adolescent women below 20 year age.
METHODS
A retrospective review was conducted on patients diagnosed endometriosis on operation below 20 year age at Cheil General Hospital between January 2001 and October 2010. Clinical characteristics, treatment results and follow-up data for 79 women were collected.
RESULTS
The mean age at operation was 18.5 year age, and in 5 cases (6.3%) the operation was performed at < or = 15 year age. Mullerian anomalies were accompanied in 6 cases (7.6%). Seventy-nine per cent of patients had pain associated symptoms such as dysmenorrhea, non cyclic pelvic pain, and gastrointestinal pain. Endometriosis was found to be stage I in 20.3% of patients, stage II in 7.6% of patients, stage III in 40.5% of patients and stage IV in 31.6% of patients. We could not find any recurrence in patients with stage I and II endometriosis, however patients with stage III and IV endometriosis showed recurrence rates of 15.6% and 28.0%, respectively, during the mean follow-up period (33.7 +/- 28.5 months). During the 36-month follow-up, the cumulative proportion of subjects free from endometrioma recurrence was 82.5%, but the rate increased as the follow-up period was extended.
CONCLUSION
Endometriosis can occur in adolescents and the recurrence rate is higher in advanced stage. As endometriosis is a progressive disease, early diagnosis and treatment during adolescence may be necessary.

Keyword

Endometriosis; Adolescent; Recurrence; Mullerian anomaly

MeSH Terms

Adolescent
Dysmenorrhea
Early Diagnosis
Endometriosis
Female
Follow-Up Studies
Hospitals, General
Humans
Pelvic Pain
Prognosis
Recurrence
Retrospective Studies

Figure

• 

  Fig. 1. (A) Cumulative recurrence of endometriomas during the follow up period. (B) Cumulative recurrence of endometriomas according to the stage of endometriosis during the follow up period (dark line; stage III, dotted line; stage IV).

Reference

1. Goldman MB, Cramer DW. The epidemiology of endometriosis. Prog Clin Biol Res. 1990; 323:15–31.

2. American College of Obstetricians and Gynecologists. ACOG Committee Opinion. Number 310, April 2005. Endometriosis in adolescents. Obstet Gynecol. 2005; 105:921–7.

3. Schroeder B, Sanfilippo JS. Dysmenorrhea and pelvic pain in adolescents. Pediatr Clin North Am. 1999; 46:555–71.

4. Laufer MR, Goitein L, Bush M, Cramer DW, Emans SJ. Prevalence of endometriosis in adolescent girls with chronic pelvic pain not responding to conventional therapy. J Pediatr Adolesc Gynecol. 1997; 10:199–202.

5. Reese KA, Reddy S, Rock JA. Endometriosis in an adolescent population: the Emory experience. J Pediatr Adolesc Gynecol. 1996; 9:125–8.

6. Vercellini P, Fedele L, Arcaini L, Bianchi S, Rognoni MT, Candi-ani GB. Laparoscopy in the diagnosis of chronic pelvic pain in adolescent women. J Reprod Med. 1989; 34:827–30.

7. Schifrin BS, Erez S, Moore JG. Teen-age endometriosis. Am J Obstet Gynecol. 1973; 116:973–80.

8. Goldstein DP, deCholnoky C, Leventhal JM, Emans SJ. New insights into the old problem of chronic pelvic pain. J Pediatr Surg. 1979; 14:675–80.

9. Gao X, Yeh YC, Outley J, Simon J, Botteman M, Spalding J. Health-related quality of life burden of women with endometriosis: a literature review. Curr Med Res Opin. 2006; 22:1787–97.

10. Goldstein DP, De Cholnoky C, Emans SJ. Adolescent endometriosis. J Adolesc Health Care. 1980; 1:37–41.

11. Cho HJ, Bai SW, Kim JY, Lee KJ, Cho DJ, Song CH, et al. Study on endometriosis in an adolescent population. Korean J Obstet Gynecol. 2001; 44:679–82.

13. Mais V, Guerriero S, Ajossa S, Angiolucci M, Paoletti AM, Melis GB. The efficiency of transvaginal ultrasonography in the diagnosis of endometrioma. Fertil Steril. 1993; 60:776–80.

14. Laufer MR, Sanfilippo J, Rose G. Adolescent endometriosis: diagnosis and treatment approaches. J Pediatr Adolesc Gynecol. 2003; 16:S3–11.

15. Klein JR, Litt IF. Epidemiology of adolescent dysmenorrhea. Pediatrics. 1981; 68:661–4.

16. Chapron C, Lafay-Pillet MC, Monceau E, Borghese B, Ngô C, Souza C, et al. Questioning patients about their adolescent history can identify markers associated with deep infiltrating endometriosis. Fertil Steril. 2011; 95:877–81.

17. Ballard K, Lowton K, Wright J. What's the delay? A qualitative study of women's experiences of reaching a diagnosis of endometriosis. Fertil Steril. 2006; 86:1296–301.

18. Hadfield R, Mardon H, Barlow D, Kennedy S. Delay in the diagnosis of endometriosis: a survey of women from the USA and the UK. Hum Reprod. 1996; 11:878–80.

19. Stavroulis AI, Saridogan E, Creighton SM, Cutner AS. Laparoscopic treatment of endometriosis in teenagers. Eur J Obstet Gynecol Reprod Biol. 2006; 125:248–50.

20. Colditz GA. Oral contraceptive use and mortality during 12 years of follow-up: the Nurses’ Health Study. Ann Intern Med. 1994; 120:821–6.