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Clinical presentation of endometriosis identified at interval laparoscopic tubal sterilization: Prospective series of 465 cases.
J Gynecol Obstet Hum Reprod 2017; 46(8):647-650JG

Abstract

OBJECTIVES

Women seeking sterilization are usually parous and have no major complains, such as pelvic pain. This could be a good model to indirectly assess the prevalence of endometriosis in the general population. Prevalence of endometriosis in women undergoing tubal sterilization by laparoscopy has been assessed in 17 published reports. Results indicate a surprising wide variation of prevalence of endometriosis, ranging from 1.4% to 43.3%. This clinical study describes the prevalence and clinical presentations of endometriosis identified at interval laparoscopic tubal sterilization, as a close representation of endometriosis in general population.

MATERIAL AND METHODS

From July 1989 to February 2009, 465 women undergone interval laparoscopic tubal sterilization and were included in this series. Surgery was realised in a non universitary centre of gynecologic surgery. All patients were operated on by the same surgeon. A complete assessement of pelvic organs was achieved with a particular attention paid for endometriotic lesions. Endometriosis when present was staged according to r-AFS classification. Biopsies were sent for pathological examination to assess endometriosis.

RESULTS

Mean age of women was 40.7 years (range 15-49 years). 20 women were nulliparous and 12 others had a past history of endometriosis. Endometriosis was visually identified in 55 patients (11.82%), and confirmed by histologic examination in most of cases (50/55: 90.9%). The mean age of women presenting endometriosis at the onset of tubal ligation was 41.27 years. Cases with endometriosis were classified according to the r-AFS. 39,7,8 and 1 cases corresponded to stages I, II, III and IV respectively. In the 20 nulliparous women, the prevalence of endometriosis was 20% (4/20). At the time of laparoscopic sterilization, 91 women presented a painfull condition (dysmenorrhea mainly or dyspareunia). Endometriosis was identified in 16 of them (17.58%). In the group of 360 asymptomatic parous women, the prevalence of endometriosis was 10% (36/360). Nulliparity, associated pelvic pain and retroverted uterus were associated with increased prevalence of endometriosis, without being significant.

CONCLUSION

In our study, the prevalence of endometriosis identified at interval laparoscopic tubal sterilization was 11.82%. In parous asymptomatic women, the prevalence of endometriosis was 10%. The prevalence of endometriosis was slightly increased in nulliparous women, when pain was associated and in women with a retroverted uterus.

Authors+Show Affiliations

Department of gynecology-obstetrics, Strasbourg university teaching hospitals, hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg, France. Electronic address: marion.tissot@hotmail.fr.Department of gynecology-obstetrics, Strasbourg university teaching hospitals, hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg, France.Department of gynecology-obstetrics, Strasbourg university teaching hospitals, hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg, France.IRCAD, 1, place de l'Hôpital, 67000 Strasbourg, France.Department of gynecology-obstetrics, Strasbourg university teaching hospitals, hôpital de Hautepierre, 1, avenue Molière, 67098 Strasbourg, France.Institut Robert-B.-Greenblatt, 35, rue Turenne, 33000 Bordeaux, France.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28526518

Citation

Tissot, M, et al. "Clinical Presentation of Endometriosis Identified at Interval Laparoscopic Tubal Sterilization: Prospective Series of 465 Cases." Journal of Gynecology Obstetrics and Human Reproduction, vol. 46, no. 8, 2017, pp. 647-650.
Tissot M, Lecointre L, Faller E, et al. Clinical presentation of endometriosis identified at interval laparoscopic tubal sterilization: Prospective series of 465 cases. J Gynecol Obstet Hum Reprod. 2017;46(8):647-650.
Tissot, M., Lecointre, L., Faller, E., Afors, K., Akladios, C., & Audebert, A. (2017). Clinical presentation of endometriosis identified at interval laparoscopic tubal sterilization: Prospective series of 465 cases. Journal of Gynecology Obstetrics and Human Reproduction, 46(8), pp. 647-650. doi:10.1016/j.jogoh.2017.05.003.
Tissot M, et al. Clinical Presentation of Endometriosis Identified at Interval Laparoscopic Tubal Sterilization: Prospective Series of 465 Cases. J Gynecol Obstet Hum Reprod. 2017;46(8):647-650. PubMed PMID: 28526518.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical presentation of endometriosis identified at interval laparoscopic tubal sterilization: Prospective series of 465 cases. AU - Tissot,M, AU - Lecointre,L, AU - Faller,E, AU - Afors,K, AU - Akladios,C, AU - Audebert,A, Y1 - 2017/05/17/ PY - 2017/02/19/received PY - 2017/05/01/revised PY - 2017/05/09/accepted PY - 2017/5/21/pubmed PY - 2019/6/25/medline PY - 2017/5/21/entrez KW - Endometriosis KW - Interval laparoscopic tubal sterilization KW - Prevalence SP - 647 EP - 650 JF - Journal of gynecology obstetrics and human reproduction JO - J Gynecol Obstet Hum Reprod VL - 46 IS - 8 N2 - OBJECTIVES: Women seeking sterilization are usually parous and have no major complains, such as pelvic pain. This could be a good model to indirectly assess the prevalence of endometriosis in the general population. Prevalence of endometriosis in women undergoing tubal sterilization by laparoscopy has been assessed in 17 published reports. Results indicate a surprising wide variation of prevalence of endometriosis, ranging from 1.4% to 43.3%. This clinical study describes the prevalence and clinical presentations of endometriosis identified at interval laparoscopic tubal sterilization, as a close representation of endometriosis in general population. MATERIAL AND METHODS: From July 1989 to February 2009, 465 women undergone interval laparoscopic tubal sterilization and were included in this series. Surgery was realised in a non universitary centre of gynecologic surgery. All patients were operated on by the same surgeon. A complete assessement of pelvic organs was achieved with a particular attention paid for endometriotic lesions. Endometriosis when present was staged according to r-AFS classification. Biopsies were sent for pathological examination to assess endometriosis. RESULTS: Mean age of women was 40.7 years (range 15-49 years). 20 women were nulliparous and 12 others had a past history of endometriosis. Endometriosis was visually identified in 55 patients (11.82%), and confirmed by histologic examination in most of cases (50/55: 90.9%). The mean age of women presenting endometriosis at the onset of tubal ligation was 41.27 years. Cases with endometriosis were classified according to the r-AFS. 39,7,8 and 1 cases corresponded to stages I, II, III and IV respectively. In the 20 nulliparous women, the prevalence of endometriosis was 20% (4/20). At the time of laparoscopic sterilization, 91 women presented a painfull condition (dysmenorrhea mainly or dyspareunia). Endometriosis was identified in 16 of them (17.58%). In the group of 360 asymptomatic parous women, the prevalence of endometriosis was 10% (36/360). Nulliparity, associated pelvic pain and retroverted uterus were associated with increased prevalence of endometriosis, without being significant. CONCLUSION: In our study, the prevalence of endometriosis identified at interval laparoscopic tubal sterilization was 11.82%. In parous asymptomatic women, the prevalence of endometriosis was 10%. The prevalence of endometriosis was slightly increased in nulliparous women, when pain was associated and in women with a retroverted uterus. SN - 2468-7847 UR - https://www.unboundmedicine.com/medline/citation/28526518/Clinical_presentation_of_endometriosis_identified_at_interval_laparoscopic_tubal_sterilization:_Prospective_series_of_465_cases_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2468-7847(17)30114-9 DB - PRIME DP - Unbound Medicine ER -