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 (2-hop)

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. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (41)

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