Al-Jafari Mohammad, Aldarawsheh Marah Ahmad, Abouzid Mohamed, Serag Ibrahim, Nofal Mariam Akram, Altiti Ammar Ra'ed, Zuaiter Saja, Al-Zurgan Aya Sabri, Aldiabat Basil, Owaidat Julie Feras, Eddin Sadeen Zein, Sawas Wedad Ahmad, Muhaidat Nadia, Alkhawaldeh Ibraheem M, Al-Kharabsheh Ahlam M, Al-Ajlouni Yazan A
Faculty of Medicine, Mutah University, Al-Karak, Jordan.
Al-Bashir Hospital, Amman, Jordan.
BMC Womens Health. 2024 Dec 28;24(1):669. doi: 10.1186/s12905-024-03527-9.
Endometriosis, a condition that significantly impacts the quality of life for affected women, manifests with a spectrum of symptoms ranging from mild discomfort to severe pelvic pain, dysmenorrhea, dyspareunia, and infertility. A previous single-center study suggested an elevated prevalence of endometriosis in Jordan, prompting the need for larger studies to confirm these findings.
We conducted a cross-sectional study involving a sample of 866 women who underwent various laparoscopic procedures for different indications at the Department of Obstetrics and Gynecology at Jordan University Hospital and Al-Karak Governmental Hospital, two tertiary referral hospitals in Jordan between January 2015 and March 2023.
Our study included 866 patients who underwent gynecological laparoscopic surgery between 2015 and 2023, with a mean age of 33.80 ± 7.7 years. Of these, 89 women were diagnosed with endometriosis, resulting in an overall prevalence of 10.3%. Diagnostic laparoscopy was the most common procedure, performed on 28.4% of patients. Infertility was the most common indication, observed in 34.5% of patients. Endometriosis was significantly more prevalent in patients with chronic pelvic pain (29.7%) and less prevalent in those seeking treatment for infertility (13.8%), ectopic pregnancy (1.1%), and family planning (0%). Endometriosis was significantly less prevalent in patients undergoing laparoscopic salpingectomy or salpingostomy (3.7%). Backstep-wise multivariate regression analysis suggested that endometriosis may be associated with higher age (OR 1.04, 95%CI 1.00 to 1.07, p = 0.027), lower BMI (OR 0.92, 95%CI 0.87 to 0.98, p = 0.007), lower number of parities (OR 0.72, 95%CI 0.6 to 0.86, p < 0.001), and fewer cesarean sections (OR 0.53, 95%CI 0.32 to 0.87, p = 0.013).
This is the most extensive Jordanian study assessing the prevalence of endometriosis in women undergoing gynecological laparoscopy. Our results suggest that the prevalence of endometriosis among Jordanian women remains high, albeit lower than previously reported. The study uncovered that age, BMI, parity number, and cesarean sections are predictors of endometriosis. Future research may explore causative reasons for the higher prevalence of endometriosis and the influence of other comorbidities, medications, and lifestyle factors.
子宫内膜异位症严重影响患病女性的生活质量，症状表现多样，从轻微不适到严重盆腔疼痛、痛经、性交困难及不孕。此前一项单中心研究表明约旦子宫内膜异位症患病率较高，因此需要开展更大规模研究以证实这些发现。
我们进行了一项横断面研究，样本为2015年1月至2023年3月期间在约旦的两家三级转诊医院——约旦大学医院妇产科和卡拉克政府医院，因不同适应证接受各种腹腔镜手术的866名女性。
我们的研究纳入了2015年至2023年间接受妇科腹腔镜手术的866例患者，平均年龄为33.80±7.7岁。其中，89名女性被诊断为子宫内膜异位症，总体患病率为10.3%。诊断性腹腔镜检查是最常见的手术，28.4%的患者接受了该手术。不孕是最常见的适应证，34.5%的患者有此情况。子宫内膜异位症在慢性盆腔疼痛患者中更为常见（29.7%），而在因不孕（13.8%）、异位妊娠（1.1%）和计划生育（0%）寻求治疗的患者中患病率较低。接受腹腔镜输卵管切除术或输卵管造口术的患者中，子宫内膜异位症的患病率显著较低（3.7%）。逐步多因素回归分析表明，子宫内膜异位症可能与年龄较大（OR 1.04，95%CI 1.00至1.07，p = 0.027）、体重指数较低（OR 0.92，95%CI 0.87至0.98，p = 0.007）、产次较少（OR 0.72，95%CI 0.6至0.86，p < 0.001）和剖宫产次数较少（OR 0.53，95%CI 0.32至0.87，p = 0.013）有关。
这是约旦评估接受妇科腹腔镜手术女性子宫内膜异位症患病率的规模最大的研究。我们的结果表明，约旦女性子宫内膜异位症患病率仍然较高，尽管低于此前报道。该研究发现年龄、体重指数、产次和剖宫产次数是子宫内膜异位症的预测因素。未来研究可探索子宫内膜异位症患病率较高的原因以及其他合并症、药物和生活方式因素的影响。
