Epidemiology and risk factors associated with laparoscopically\ndiagnosed typical and atypical endometriosis among Egyptian women

Hassanin, M.S.; Darwish, Atef M.

Epidemiology and risk factors associated with laparoscopically\ndiagnosed typical and atypical endometriosis among Egyptian women

Hassanin, M.S., Darwish, Atef M.

2013 · W6981519866

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This prospective cross-sectional study evaluated the prevalence and risk factors of laparoscopically diagnosed typical and atypical endometriosis in 2,493 Egyptian women undergoing diagnostic procedures. The researchers found that 18.8% of participants had endometriosis, with subtle forms being slightly more common than typical lesions, particularly among those seeking infertility care or suffering from chronic pelvic pain. Statistical analysis identified younger age, low parity, and urban residence as significant correlates for the disease, while noting that biopsy confirmation strongly aligned with visual laparoscopic diagnosis. This paper is centrally about endometriosis — specifically examining the epidemiology and demographic risk factors for both typical and atypical lesions in an Egyptian cohort.

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Abstract

Objectives: To estimate the prevalence of typical and atypical (subtle)\npelvic endometriosis as diagnosed by laparoscopy, and to define risk\nfactors for this disease among Egyptian women. Design: A prospective\ncross-sectional observational study. Setting: Gynecologic Endoscopy\nUnits, Assiut and Al-Azhar University Hospitals, Egypt. Materials and\nmethods: A total of 2493 patients submitted to video-assisted\nlaparoscopy due to any indication. Diagnostic laparoscopy for evidence\nof typical or subtle endometriotic ovarian, tubal or peritoneal\nlesions. Biopsy from the lesion was frequently taken for\nhistopathological evaluation. Main outcome measures: Laparoscopic and\nhistopathologic diagnosis of pelvic endometriosis. Correlating the\ndifferent patient characteristics and the risk of endometriosis.\nResults: Laparoscopically, 469 patients (18.8%) were diagnosed to be\nendometriosis. Of those, typical and atypical endometriosis were\ndiagnosed in 220 patients (8.8%) and 249 patients (9.98%) respectively.\nLaparoscopy was indicated as a part of infertility work-up in 2017\npatients (80.9%), for chronic pelvic pain in 304 patients (12.2%), and\nother indications in 172 patients (6.9%). Endometriosis was diagnosed\nin 182 (38.8%), 219 (46.6%), and 68(14.5%) patients in the 3 groups\nrespectively. Biopsy was taken from 367 cases (78.2%) and significantly\ncorrelated with laparoscopy (P=0.001, OR=0.8, 95% CI (0.4 -1.5).\nConcerning risk factors, only decreased patient’s age (less than\n30 years), low parity, and urban residence were significantly\ncorrelated with endometriosis. ORs were 0.8, 0.8, and 0.9 with 95% CI\nof 0.7-3.4, 0.4 -1.6, and 0.4 -1.2 for the 3 risk factors respectively.\nConclusions: Pelvic endometriosis is a common frequently underestimated\nhealth problem in Egypt. It is correlated with patient’s age less\nthan 30 years, low parity and urban residence. It should be considered\nin infertile women and patients with pelvic pain specially those with\nprior pelvic surgery. Being more commonly diagnosed, subtle\nendometriosis deserves large sample-sized studies of its impact on\nwomen’s health and fertility.

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Abstract

Description

Objectives

To estimate the prevalence of typical and atypical (subtle) pelvic endometriosis as diagnosed by laparoscopy, and to define risk factors for this disease among Egyptian women. Design: A prospective cross-sectional observational study. Setting: Gynecologic Endoscopy Units, Assiut and Al-Azhar University Hospitals, Egypt. Materials and

Methods

A total of 2493 patients submitted to video-assisted laparoscopy due to any indication. Diagnostic laparoscopy for evidence of typical or subtle endometriotic ovarian, tubal or peritoneal lesions. Biopsy from the lesion was frequently taken for histopathological evaluation. Main outcome measures: Laparoscopic and histopathologic diagnosis of pelvic endometriosis. Correlating the different patient characteristics and the risk of endometriosis.

Results

Laparoscopically, 469 patients (18.8%) were diagnosed to be endometriosis. Of those, typical and atypical endometriosis were diagnosed in 220 patients (8.8%) and 249 patients (9.98%) respectively. Laparoscopy was indicated as a part of infertility work-up in 2017 patients (80.9%), for chronic pelvic pain in 304 patients (12.2%), and other indications in 172 patients (6.9%). Endometriosis was diagnosed in 182 (38.8%), 219 (46.6%), and 68(14.5%) patients in the 3 groups respectively. Biopsy was taken from 367 cases (78.2%) and significantly correlated with laparoscopy (P=0.001, OR=0.8, 95% CI (0.4 -1.5). Concerning risk factors, only decreased patient’s age (less than 30 years), low parity, and urban residence were significantly correlated with endometriosis. ORs were 0.8, 0.8, and 0.9 with 95% CI of 0.7-3.4, 0.4 -1.6, and 0.4 -1.2 for the 3 risk factors respectively.

Conclusions

Pelvic endometriosis is a common frequently underestimated health problem in Egypt. It is correlated with patient’s age less than 30 years, low parity and urban residence. It should be considered in infertile women and patients with pelvic pain specially those with prior pelvic surgery. Being more commonly diagnosed, subtle endometriosis deserves large sample-sized studies of its impact on women’s health and fertility.

Keywords

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Condition tags

endometriosischronic_pelvic_paininfertility

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