Endometriosis

Laparoscopy was performed on 140 female adolescents (aged 10 to 19 years) for chronic pelvic pain at Boston Children's Hospital Medical Center. Endometriosis (without other pelvic pathology) was encountered in 47% of these patients. Pelvic pain was both cyclic and acyclic and typically began 2.9 years after menarche. Other symptoms included irregular menses, gastrointestinal and bladder symptoms, and increased vaginal discharge. The diagnosis of endometriosis had not been made preoperatively in the majority of patients despite repeated pelvic examinations and thorough evaluation of gastrointestinal and genitourinary tracts. The most constant physical finding preoperatively was tenderness with or without cul-de-sac nodularity. Comment: Endometriosis is a disorder of the female reproductive tract characterized by the finding of endometrial tissue in locations outside the uterine cavity.