Clinically Characteristic Analysis of 22 Patients with Postmenopausal Endometriosis

Objective:To describe the clinical feature of postmenopausal endometriosis.Methods:From June 1993 to June 2002,there were 22 patients of postmenopausal endometriosis treated with surgery in our hospital.Clinical data were analyzed retrospectively.Results:The average age was 55.6±4.8 years old.The average period of menopause was 5.6±3.7 years.8 patients had the history of dysmenorrhea,with 3 patients diagnosed of endometriosis before,one patient had received hormonal replacement therapy (HRT) for 5 years.Chief complaint included 15 cases of pelvic mass,9 cases of postmenopausal vaginal bleeding,2 cases of increased discharge and one chronic pelvic pain.Endometriosis were not preoperatively considered in 19 cases.All patients underwent total hysterectomy and bilateral salpingo-oophorectomy.Stages of rAFS were 3 cases of stage I and II,19 cases of stage III and IV.The final pathologic findings of 22 cases were endometriosis with leiomyoma in 13 cases,adenomyosis in 7,endometrial carcinoma in 2 and ovarian cancer in 1.12 patients had followed up for more than 6 months,and 7 of them received HRT without evidence of recurrence.Conclusions:Postmenopausal endometriosis was most likely the persistence of premenopausal endometriosis.Because its clinical picture was atypical and it was often consistent with other hormone-dependent diseases,it was often misdiagnosed.Total hysterectomy and bilateral salpingo-oophorectomy was the critical methods for diagnosis and treatment.Postoperative HRT seemed not to result in relapse.