The Prevalence of Endometriosis in Adolescents with Pelvic Pain: A Systematic Review

Martin Hirsch, Rima Dhillon‐Smith, Rima Dhillon-Smith, Alfred Cutner, Alfred S Cutner, Cutner AS, Magnus Yap, Yap M, Creighton SM, Sarah Creighton, Sarah M Creighton
Journal of pediatric and adolescent gynecology · 2020 · vol. 33(6) , pp. 623–630 · doi:10.1016/j.jpag.2020.07.011 · PMID:32736134 · W3046071067
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This systematic review aimed to determine the prevalence of endometriosis among adolescents presenting with pelvic pain.

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Abstract

Study objectiveEndometriosis is a recognized cause of pelvic pain in adolescents with menstrual symptoms that significantly affect education, activity, and social interactions. We aim to provide an updated systematic review of the prevalence of endometriosis in adolescents with pelvic pain presenting for gynecological investigation.Data sourcesWe searched Medline, Embase, and Cinahl from 2011 to July 2019.Methods of study selectionWe included cohort studies of adolescents with pelvic pain undergoing gynecological investigation. Two authors independently selected studies and extracted study characteristics and prevalence data. Methodological quality was assessed using the Critical Appraisal Skills Program for cohort studies.ResultsThis updated systematic review evaluated a total of 19 studies including 1243 symptomatic adolescents. In all, 648 of 1011 (64%) adolescents undergoing laparoscopy were found to have endometriosis. The prevalence ranged from 25% to 100%, with a mean prevalence of 64%. Thirteen studies including 381 participants categorized disease severity using the revised American Society of Reproductive Medicine classification. Among these, 53% of participants (201/381) had stage I, 28% (105/381) had stage II, 20% (76/381) had stage III, and 13% (49/381) had stage IV disease.ConclusionsThe prevalence of endometriosis among adolescents with pelvic pain symptoms is high. Endometriosis is treatable, and prompt recognition will help to ensure that adolescents are signposted earlier to appropriate specialists. The management of adolescents with suspected endometriosis should be consistent with best practice guidance. Despite recommendations to increase the awareness and knowledge of endometriosis in adolescence, minimal research has followed.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Endometriosis Endometriosis Pelvic Pain Severity of Illness Index Adolescent Biopsy Cohort Studies Endometriosis Endometriosis Female Humans Laparoscopy Magnetic Resonance Imaging Pelvic Pain Prevalence Ultrasonography

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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