Endometriosis Persisting After Castration
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Abstract
OBJECTIVE: To identify the clinical characteristics and response to surgical treatment of endometriosis-associated pain in castrated women. METHODS: In a prospective, longitudinal observational study, 75 patients with previous castration had biopsy-proven endometriosis excised surgically. Anatomical characteristics of disease were studied using pelvic mapping and compared to the findings in non-castrated women with endometriosis. Preoperative and postoperative verbal analogue pain scales were used to gauge the response to excision of endometriosis. RESULTS: Patients treated surgically for endometriosis following castration were significantly older (37.8 +/- 8.1 versus 31.3 +/- 6.9 years, mean +/- standard deviation; 95% confidence interval [CI] 4.9-8.1) and slightly more likely to have intestinal involvement (risk ratio 1.3, 95% CI 0.94-1.8) than non-castrated endometriosis patients. Most had marked alleviation of pain after excision of endometriosis. CONCLUSIONS: Endometriosis can remain symptomatic after castration, with or without estrogen therapy. In such patients, there is a 33% frequency of intestinal involvement. At castration, consideration should be given to removal of invasive peritoneal and intestinal disease. Symptom improvement occurs in most patients after excision of endometriosis.
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- Endométriose colorectale. Diagnostic et prise en charge 2001
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- CASE REPORT: Rectal Passage of Intestinal Endometriosis 2001
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- Review of pain associated with minimal endometriosis. 2000
- Current Drug Therapy Recommendations for the Treatment of Endometriosis 1999
- Combined Medical and Surgical Treatment of Women with Endometriosis 1999
- Excision of endometriosis with laparosonic coagulating shears 1999
- Hormone replacement therapy following hysterectomy for endometriosis 1998
- Endometriosis: identification by carbonic anhydrase autoantibodies and clinical features. 1997
- Hystérectomie pour endométriose : avec ou sans ovariectomie 1996
- Re: Renal and Diaphragmatic Endometriosis De Novo Associated with Hormone Replacement Therapy 1995
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