Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China.
Reprod Health. 2023 Oct 21;20(1):156. doi: 10.1186/s12978-023-01702-z.
The aim of the study is to investigate the proportion and clinical features of previous spontaneously ruptured ovarian endometrioma among women who underwent elective surgery for endometrioma.
This retrospective study was based on a cohort of elective surgeries for endometrioma performed by the same gynecologic team at Peking Union Medical College Hospital from January 2017 to October 2022. Patients diagnosed with previous spontaneously ruptured endometrioma during elective surgery were enrolled in the ruptured group. In the same cohort, patients with unruptured endometrioma treated during the same period were selected as the unruptured group by 1:2 matching according to age. Demographic and clinical information were collected and compared between two groups.
A total of 422 patients in the cohort were diagnosed with endometrioma. There were 38 patients (9.0%) in ruptured group and 76 patients in unruptured group. All enrolled participants were treated by laparoscopic surgery. In ruptured group, 86.8% patients had a history of acute abdominal pain, which was only 13.2% in unruptured group (P < 0.001). Compared to unruptured group, patients diagnosed with ruptured endometrioma had a lower BMI (P = 0.021), larger maximum diameter of endometrioma (P = 0.040), higher proportion of cul-de-sac partial obliteration rather than complete obliteration (P = 0.003).
Spontaneous rupture of endometrioma is not rare. The proportion of spontaneous rupture of endometrioma in our study was higher than that reported in the literatures. In women with endometrioma, the onset of acute abdominal pain should be considered a rupture of cyst, especially in patients with big cysts.
本研究旨在探讨择期手术治疗的卵巢子宫内膜异位囊肿患者中既往自发破裂子宫内膜异位囊肿的比例及临床特征。
本回顾性研究基于北京协和医院同一妇科团队于 2017 年 1 月至 2022 年 10 月期间进行的择期手术治疗子宫内膜异位症的队列。在择期手术中诊断为既往自发破裂子宫内膜异位症的患者被纳入破裂组。在同一队列中，选择同期治疗的未破裂子宫内膜异位症患者按年龄 1:2 匹配为未破裂组。收集并比较两组患者的人口统计学和临床资料。
该队列中共有 422 例患者被诊断为子宫内膜异位症。破裂组 38 例（9.0%），未破裂组 76 例。所有入组患者均接受腹腔镜手术治疗。破裂组中，86.8%的患者有急性腹痛病史，而未破裂组中仅有 13.2%（P<0.001）。与未破裂组相比，诊断为破裂型子宫内膜异位症的患者 BMI 较低（P=0.021），子宫内膜异位症最大直径较大（P=0.040），且子宫直肠窝部分闭塞而非完全闭塞的比例较高（P=0.003）。
子宫内膜异位症自发破裂并不罕见。本研究中子宫内膜异位症自发破裂的比例高于文献报道。在子宫内膜异位症患者中，急性腹痛的发作应考虑为囊肿破裂，尤其是在大囊肿患者中。
