Endometriosis in an Indigenous African Women Population

Abstract Introduction Endometriosis is a condition in which endometrial tissue exists outside the endometrial cavity. It has a high prevalence in women living in developed countries and is reportedly the third most common cause of gynecologic hospitalization in the United States. It is believed to be rare among indigenous African women, although studies on its prevalence in this population are few. This study aims to determine the prevalence and clinical presentation of the condition in an indigenous African population. Methods This is a retrospective study of gynecological specimens received in the Histopathology Laboratory of Enugu State University Teaching Hospital from January 1, 2014, to December 31, 2018. Laboratory request forms and histopathology reports archived in the laboratory were retrieved and relevant information about patients diagnosed with endometriosis was extracted and analyzed by simple statistical methods. Results There were 25 diagnosed cases of endometriosis representing 0.9% of gynecological specimens received in the period. Patients’ average age was 38.4 ± 8.4 years while the peak age range was 31 to 40 years (n = 10; 40%). Myometrium was the most common site (n = 16; 64%), followed by the ovary (n = 5; 20%). The umbilicus, round ligament, broad ligament, and suprapubic region constituted 1 (4%), respectively. The most common symptoms were pelvic pain (36%) and abnormal uterine bleeding (32%) while recurrent ascites occurred in 1 (4%). There was associated primary and secondary infertility in 20% and 16% of cases, respectively. Recurrent abortion occurred in 4 (8%) of cases. The umbilical and suprapubic masses had symptoms, bleeding, and tender swelling, respectively, that synchronized with the patient’s menstrual cycle. Conclusion Endometriosis has a low prevalence in our population but occurs in rare sites. Women presenting with chronic pelvic pain and infertility and menstrual disorders should be evaluated for endometriosis. Population-based study is required to properly determine the actual prevalence of the condition in this population.