External genital endometriosis post-surgery hemostasis parameters

B. Baigalmaa, В. О. Бицадзе, А. Г. Солопова, A. Е. Efanov, A. Е. Voynovskiy
In: Obstetrics, Gynecology and Reproduction · 2024 · vol. 18(5) , pp. 648–657 · doi:10.17749/2313-7347/ob.gyn.rep.2024.575 · W4404141620
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

External genital endometriosis patients exhibited a subclinical thrombogenesis risk, which improved post-surgery with hemostasis normalization during rehabilitation.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This prospective interventional comparative controlled study examined hemostasis system biomarkers in 120 women: 40 with external genital endometriosis (EGE) scheduled for surgery, 40 with other benign gynecologic conditions undergoing surgery, and 40 healthy controls. Hemostasis was assessed at three visits over a 3-month follow-up using ADAMTS-13, von Willebrand factor (vWF), D-dimer, protein C, antithrombin III, and APTT/Rarus-test. Before surgery, women with EGE showed a subclinical but significant increase in procoagulant markers, particularly vWF and D-dimer; after surgery there was an early rise in specific procoagulant factors, followed by partial normalization at 3 months with some biomarker decreases relative to preoperative values, while group differences remained statistically significant. This paper is centrally about endometriosis — it specifically investigates post-surgery dynamics of hemostasis parameters in external genital endometriosis.

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Abstract

Introduction. Endometriosis is one of the common diseases with poorly elucidated underlying nature and pathogenetic mechanisms. Clinical trials suggest that women suffering from it have hemostasis disorders. However, the severity of relevant changes and their origin remain debated. Aim: to study the dynamics of hemostasis system parameters in patients underwent surgical treatment of external genital endometriosis (EGE). Materials and Methods. A total of 120 women were enrolled into the prospective interventional comparative controlled study: 40 patients with EGE scheduled for surgical treatment (main group), 40 patients with other benign gynecological diseases requiring surgical intervention (comparison group), and 40 apparently healthy women (control group). Нemostasis system status was assessed based on the results of 3 visits during 3 month-follow-up by assessing the following biomarkers: metalloproteinase ADAMTS-13 (a disintegrin and metalloproteinase with thrombospondin type 1 motif, member 13), von Willebrand factor (vWF), D-dimer, protein C, antithrombin III (AT-III), activated partial thromboplastin time (APTT) and Рarus-test values. Results. Prior to surgery, among EGE women a subclinical but significant increase in procoagulant biomarkers was observed compared to other groups: vWF – 1.24 [1.17–1.35] U/ml, D-dimer – 173.5 [73.5–221.23] ng/ml. Evaluation of the remaining parameters showed no clinical significance of the observed changes. The endometriosis-related surgical intervention was accompanied by increase in specific procoagulant factors a week post-treatment apparently associated with surgical manipulations. However, 3 months later, hemostasis system status partially normalized as revealed by lower biomarkers examined, which in some cases were significantly decreased compared to those observed before surgery. At the same time, differences between the study groups remained statistically significant. Conclusion. Patients with EGE were noted to have a subclinical risk of thrombogenesis. Upon this, surgical treatment and rehabilitation during recovery period allowed to improve overall state of the hemostasis system, thereby reducing a thrombogenesis risk.

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endometriosis

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