Endosalpingiosis-an underestimated cause of chronic pelvic pain or an accidental finding? A retrospective study of 16 cases

OBJECTIVE: The relevance of endosalpingiosis as a cause of chronic pelvic pain is controversial. To examine the clinical presentation of endosalpingiosis, the files of the Institute of Pathology at the University of Münster for the years 1994-1999 were screened by keyword search for the diagnosis of endosalpingiosis and the patient files were reviewed. PATIENTS: Thirteen patients with the diagnosis endosalpingiosis treated at our institution were identified within the past 6 years. Five patients (38%) presented with pelvic pain, five (38%) with hyper- or dysmenorrhea, five (38%) patients had no complaints at all, one of these had primary and one had secondary infertility, three had persistent ovarian cysts. The diagnosis of endosalpingiosis was confirmed by a second pathologist for all patients included in this study. RESULTS: Mean age at diagnosis was 43 (range 24-82), of the five patients presenting with pelvic pain, the localization of endosalpingiosis was consistent with the localization of pain in only four (30%) patients. Localization and macroscopic appearance of endosalpingiosis and endometriosis seems to be the same in our cases. Five (38%) patients suffered from myomatous uterus, five (38%) had additional endometriosis, five (15%) patients had hydrosalpinx (postinflammatory tubal disease), and seven (53%) had pelvic adhesions. Nine patients had previously been admitted for surgery, only two (15%) patients had tubal surgery, two (15%) had cesarian section and five (38%) had a history of more than two abdominal operations. Eleven (85%) cases of endosalpingiosis were diagnosed by the same pathologist. CONCLUSIONS: Endosalpingiosis seems to be an accidental finding, associated with additional pelvic pathology, rather than being a frequent cause of pelvic pain.