Takahashi Nozomi, Harada Miyuki, Kanatani Mayuko, Wada-Hiraike Osamu, Hirota Yasushi, Osuga Yutaka
Department of Obstetrics and Gynecology, Faculty of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo, Tokyo 113-8655, Japan.
Biomedicines. 2024 Mar 14;12(3):651. doi: 10.3390/biomedicines12030651.
It is unclear whether clinical background differs between endometriosis in adolescent patients with obstructive Müllerian anomalies and those without anomalies. The aim of the study is to identify the difference in clinical characteristics of endometriosis in patients with or without obstructive Müllerian anomalies. The study involved 12 patients aged under 24 years old who underwent primary surgery for obstructive Müllerian anomalies and 31 patients aged under 24 years old who underwent surgery for ovarian endometrioma. A total of 6 out of 12 cases with obstructive Müllerian anomalies developed endometriosis (4 Herlyn-Werner-Wunderlich syndrome, 2 non-communicating functional uterine horn, 2 cervical aplasia). The age at surgery was significantly younger in endometriosis with obstructive Müllerian anomalies, compared with those without obstructive Müllerian anomalies (17.8 ± 4.4 vs. 23.1 ± 1.3, = 0.0007). The rate of endometrioma was 50.0% and the rate of hydrosalpinx was significantly higher (66.7% vs. 0%, = 0.0002) in the group of obstructive Müllerian anomalies. The recurrence rate of endometriosis was 20.0% in the group of anomalies and 25.9% in the group of those without anomalies. Adolescent patients with obstructive Müllerian anomalies more easily developed endometriosis and co-occurred with higher rate of hematosalipinx.
目前尚不清楚,患有梗阻性苗勒管异常的青少年患者与未患异常的青少年患者相比,其临床背景是否存在差异。本研究的目的是确定患有或未患有梗阻性苗勒管异常的患者,子宫内膜异位症临床特征的差异。该研究纳入了12名24岁以下因梗阻性苗勒管异常接受初次手术的患者,以及31名24岁以下因卵巢子宫内膜异位囊肿接受手术的患者。12例梗阻性苗勒管异常病例中,共有6例发生了子宫内膜异位症(4例为赫林-韦尔纳-温德利希综合征,2例为非交通性功能性子宫角,2例为宫颈发育不全)。与无梗阻性苗勒管异常的子宫内膜异位症患者相比,有梗阻性苗勒管异常的子宫内膜异位症患者手术时年龄显著更小(17.8±4.4岁 vs. 23.1±1.3岁,P = 0.0007)。梗阻性苗勒管异常组的子宫内膜异位囊肿发生率为50.0%,输卵管积水发生率显著更高(66.7% vs. 0%,P = 0.0002)。异常组子宫内膜异位症的复发率为20.0%,无异常组为25.9%。患有梗阻性苗勒管异常的青少年患者更容易发生子宫内膜异位症,且输卵管积血发生率更高。