Epidemiology of endometriosis in female evacuated from the Eastern Ukrainian military conflict regions: results a multicenter study (2022-2024)

OBJECTIVE: Aim: To estimate the prevalence and risk factors associated with endometriosis in female evacuated from the Eastern Ukrainian military conflict regions. PATIENTS AND METHODS: Materials and Methods: A prospective multicenter cohort study was based on surveillance data for endometriosis. 982 women undergoing pelvic surgery were compared to 264 patients unexposed to surgery. The study cohort included women, who underwent a diagnostic and/or therapeutic laparoscopy or laparotomy in 2022-2024. Endometriosis among women was diagnosed visually at laparoscopy/laparotomy or by pelvic magnetic resonance imaging. RESULTS: Results: The prospective multicenter study included 1,246 women. The overall prevalence of endometriosis was 31.5%. Prevalence of the three types of endometrioses included peritoneal/superficial endometriosis, ovarian endometriotic cyst/endometrioma and deep infiltrating endometriosis was 13.8%, 9.8%, and 4.8%, respectively. Three hundred sixty-one women 36,8% in the surgical group and thirty-one women 13.3% in the community treatment group (unexposed to surgery, population cohort) were diagnosed with incident endometriosis. The pelvic pain, infertility and early age at menarche to be a consistent risk factor for endometriosis in both the operative and population cohorts. Data analysis showed that odds were decreased for gravidity, parity, and BMI. Factors that increased the odds of endometriosis diagnosis included dysmenorrhea, older age at first sex, pelvic pain as a surgical indication for laparoscopy, and higher education. CONCLUSION: Conclusions: Our study findings demonstrate the high prevalence of endometriosis among women in Ukraine. The pelvic pain, infertility and early age at menarche to be a consistent risk factor for endometriosis in both the operative and population cohorts.