Characteristics and Preoperative Management of Adolescent Patients with Pathology-Confirmed Endometriosis: A Multi-Institutional Study

Katherine Bergus, Katherine C Bergus, Bergus KC, Brenna Rachwal, Rachwal B, Asti L, Lindsey Asti, Lesley Breech, Breech LL, Lesley L Breech, Yuan Yuan Gong, Gong YY, Yuan Gong, S Paige Hertweck, Hertweck SP, Holly R Hoefgen, Hoefgen HR, Holly Hoefgen, Horne AH, Anne Horne, Anne H Horne, Ashli Lawson, Lawson A, Seema Menon, Menon S, Kathleen E O'Brien, O'Brien KE, Pradhan S, Shashwati Pradhan, Smith YR, Yolanda R Smith, Priya Suvarna, Prashant Suvarna, Suvarna P, Van Son S, Sarah Van Son, Geri Hewitt, Hewitt G
Journal of pediatric and adolescent gynecology · 2025 · vol. 38(5) , pp. 629–636 · doi:10.1016/j.jpag.2025.04.003 · PMID:40318750 · W4409994285
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This multi-institutional study characterized adolescent patients with pathology-confirmed endometriosis and examined their preoperative management strategies.

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Abstract

STUDY OBJECTIVE: This multi-institutional, observational, retrospective cohort study aimed to characterize the demographics and preoperative medical management of patients with pathology-confirmed endometriosis. METHODS: We reviewed patients <22 years at 8 tertiary care pediatric hospitals in the Midwestern United States who underwent diagnostic laparoscopy and had biopsy-confirmed endometriosis. Patients were identified through pathology records. Demographics, medical history, clinical symptoms, and prior medical management were extracted. Descriptive statistics were computed. RESULTS: Among 305 patients, median age at first presentation to pediatric and adolescent gynecology (PAG) was 15.6 years (interquartile range: 14.2-17.1). Most patients were White (83.3%) and most had commercial insurance (70.5%). Only 4.3% had a diagnosis of endometriosis prior to their initial presentation to PAG. Common symptoms included progressive dysmenorrhea (76.7%), heavy menstrual bleeding (50.8%), missed school/activities due to dysmenorrhea (55.1%). Patients sought care for their symptoms from a range of providers in addition to PAG, including primary care/adolescent medicine (75.1%), gastroenterology (18.7%), adult gynecology (22.3%), and physical therapy (13.4%). Nearly all patients (92.8%) tried oral hormonal menstrual suppression prior to laparoscopy. Hormonal management included combined oral contraception (62.3%), medroxyprogesterone acetate injection (15.7%), ≤5mg daily norethindrone (14.8%), >5mg daily norethindrone (13.4%), hormonal intrauterine system (13.1%), and contraceptive implant (5.3%). CONCLUSIONS: Patients with pathology-proven endometriosis typically presented with progressive dysmenorrhea, missed school or activities, and heavy menstrual bleeding. They sought care from a variety of providers and while most tried hormonal management of symptoms, the method used varied.

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Condition tags

dysmenorrheaendometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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