Clinical symptoms and diagnostic tools that are related to infertility and hydrosalpinx formation in women with advanced stage endometriosis complicated by endometrioma

Ali Yavuzcan, Mete Caglar, Caglar M, Dilbaz S, Serdar Dilbaz, Yusuf Ustün, Ustün Y, Ozdemir I, Ismail Ozdemir, Elif Yildiz, Yildiz E, Ozbilgeç S, Sitki Ozbilgeç, Selahattin Kumru, Kumru S
Ginekologia polska · 2013 · doi:10.17772/gp/1637 · PMID:24191514
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This study found that severe dysmenorrhea is associated with infertility in advanced endometriosis, and large endometriomas are linked to the intraoperative detection of unexpected hydrosalpinx.

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Abstract

OBJECTIVES: The study included patients suffering from stage III-IV endometriosis complicated by an endometrioma (OMA). We investigated the association between age, presence of dysmenorrhea/dyspareunia, preoperative CA 125 level, size of OMA on ultrasonographic exam and infertility as well as the risk of intraoperative detection of hydrosalpinx that was not suspected on pre-operative assessment. MATERIALS AND METHODS: The study included patients with stage III-IV endometriosis complicated by OMA who underwent a laparoscopic or open surgery due to pre-diagnosis of infertility or adnexal mass. RESULTS: Dysmenorrhea had statistically significant association with infertility (p=0.031). There was no statistically significant relation between age, dyspareunia, preoperative CA 125 level, size of OMA on ultrasonographic exam and infertility (p=0.203, p=0.561, p=0.561 and p=0.668, respectively). No statistically significant relation was found between age, CA 125 level, dysmenorrhea, dyspareunia and detection of an unilateral/bilateral hydrosalpinx, that was not suspected on pre-operative assessment (p=0.179, p=0.295, p=0.895, p=0.424, respectively). There was an association between OMA size (p=0.023) and detection of unilateral/bilateral hydrosalpinx. CONCLUSIONS: Patients who desire to have children but suffer from severe dysmenorrhea must be preoperatively informed about the possibility of having stage III-IV endometriosis. Infertile patients who are about to undergo an operation, especially due to a large OMA, may turn out to have hydrosalpinx. These patients should be informed preoperatively about the possibility of having salpingectomy or the proximal tubal surgery for improving fertility.
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Condition tags

dysmenorrheaendometriosisendometriomadyspareuniainfertility

MeSH descriptors

Endometriosis Endometriosis Infertility, Female Ovarian Cysts Ovarian Cysts Salpingitis Salpingitis Adolescent Adult Dysmenorrhea Dysmenorrhea Dysmenorrhea Endometriosis Endometriosis Female Humans Infertility, Female Infertility, Female Laparoscopy Middle Aged

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