Hanssens S, Rubod C, Kerdraon O, Vinatier D, Lucot J P, Duhamel A, Collinet P
Department of Obstetrics and Gynecology, Jeanne de Flandre Hospital, Regional University Hospital Center of Lille (CHRU), Lille cedex, France -
Minerva Med. 2015 Jun;106(3):123-31. Epub 2014 Oct 6.
The aim of this study was to describe the characteristics of women under 25 years with pelvic endometriosis and assess their potential for recurrence and fertility after surgery.
In a comparative retrospective study, 108 patients aged less than 25 years who underwent surgery for pelvic endometriosis were included: 49 in the DIE group (deep infiltrating endometriosis) and 59 in the SE group (superficial endometriosis). The main outcome measures were complications, recurrence and fertility. This study received the favorable opinion of the CEROG No 2012-GYN-04-02.
The diagnosis was made at 21.6 ± 2.8 years, mainly considering clinical signs (78.4%), and on average 4.3 ± 3.7 years after the onset of symptoms; 16.1% of patients had to be reoperated (N.=5/31) due to a recurrence of their endometriosis. There were more recurrent pain (50% vs. 21.7%, P=0.005) and endometriosis (35.7 vs. 19.6%, P=0.08) in the DIE group. 75% (N.=33/44) patients desired pregnancy after surgery and 50% of them became pregnant, with one third thanks to assisted reproductive technology.
In young women, endometriosis is often more severe. The early treatment does not improve the rate of recurrence and fertility, but can reduce pain and thus improve the quality of life.
本研究旨在描述25岁以下盆腔子宫内膜异位症女性的特征，并评估她们术后复发及生育的可能性。
在一项对比性回顾性研究中，纳入了108例年龄小于25岁且接受盆腔子宫内膜异位症手术的患者：深部浸润型子宫内膜异位症（DIE）组49例，浅表性子宫内膜异位症（SE）组59例。主要观察指标为并发症、复发及生育情况。本研究获得了CEROG第2012-GYN-04-02号的批准。
诊断时的年龄为21.6±2.8岁，主要依据临床症状（78.4%），症状出现后平均4.3±3.7年确诊；16.1%的患者（N=5/31）因子宫内膜异位症复发而需再次手术。DIE组复发性疼痛（50%对21.7%，P=0.005）和子宫内膜异位症（35.7对19.6%，P=0.08）更多见。75%（N=33/44）的患者术后希望妊娠，其中50%成功怀孕，三分之一得益于辅助生殖技术。
在年轻女性中，子宫内膜异位症往往更为严重。早期治疗虽不能提高复发率和生育率，但可减轻疼痛，从而改善生活质量。
