Smorgick Noam, As-Sanie Sawsan, Marsh Courtney A, Smith Yolanda R, Quint Elisabeth H
Department of Obstetrics and Gynecology, University of Michigan Health System, Ann Arbor, MI.
Department of Obstetrics and Gynecology, University of Michigan Health System, Ann Arbor, MI.
J Pediatr Adolesc Gynecol. 2014 Dec;27(6):320-3. doi: 10.1016/j.jpag.2013.12.010. Epub 2014 Sep 23.
To describe the prevalence and characteristics of advanced stage endometriosis in adolescents and young women treated in a tertiary referral center.
Retrospective cohort.
Tertiary referral center.
86 adolescents and young women (≤22 y) who underwent surgery for endometriosis. The operative reports were reviewed for endometriosis stage, surgical findings, surgical procedures, and pathology.
Endometriosis stage reported according to the revised American Fertility Society classification.
Early stage endometriosis (stage I or II) was found in 66 (76%) and advanced stage endometriosis (stage III or IV) in 20 (23%). The surgical findings in the 20 patients with advanced stage endometriosis included ovarian endometriomas in 14 cases, rectovaginal nodule in 1 case, and diaphragmatic and pulmonary endometriosis in 1 case. Women with advanced stage endometriosis were found to be slightly older at time of diagnosis than those with early stage disease (mean age 20.4 ± 1.4 y vs 18.7 ± 2.2 y respectively, P < .001).
In adolescents and young women with endometriosis, advanced stage disease is not uncommon. The main presentation of advanced stage endometriosis in this age group is ovarian endometriomas rather than extensive peritoneal or adhesive disease.
描述在三级转诊中心接受治疗的青少年和年轻女性中晚期子宫内膜异位症的患病率及特征。
回顾性队列研究。
三级转诊中心。
86例接受子宫内膜异位症手术的青少年和年轻女性(年龄≤22岁)。对手术报告进行回顾,以了解子宫内膜异位症分期、手术发现、手术操作及病理情况。
根据修订后的美国生育协会分类报告的子宫内膜异位症分期。
66例(76%)为早期子宫内膜异位症(I期或II期),20例(23%)为晚期子宫内膜异位症(III期或IV期)。20例晚期子宫内膜异位症患者的手术发现包括14例卵巢子宫内膜异位囊肿、1例直肠阴道结节、1例膈肌和肺部子宫内膜异位症。发现晚期子宫内膜异位症女性在诊断时的年龄略大于早期疾病患者(平均年龄分别为20.4±1.4岁和18.7±2.2岁,P<.001)。
在患有子宫内膜异位症的青少年和年轻女性中,晚期疾病并不少见。该年龄组晚期子宫内膜异位症的主要表现是卵巢子宫内膜异位囊肿,而非广泛的腹膜或粘连性疾病。