Coincidence of uterine malformations and endometriosis: a clinically relevant problem?
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GENERAL GYNECOLOGY
Coincidence of uterine malformations and endometriosis: a clinically relevant problem? Elvin Piriyev1 · Thomas Römer1 Received: 30 April 2020 / Accepted: 13 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Introduction It is suspected that uterine malformations and endometriosis have a high coincidence. Furthermore, it is expected that obstructive uterine malformations are significantly higher affected than non-obstructive malformations. The correlation between endometriosis and uterine malformations may be due to increased retrograde menstruation, which would explain a higher coincidence of obstructive malformations and endometriosis [14]. Methods This retrospective study investigates whether patients with uterine malformations have a higher prevalence of endometriosis. The study includes patients with uterine malformations who were admitted to our hospital in the period from 01.12.2014 to 30.11.2019. Results 279 cases were analysed. 263 (94.2%) patients had a non-obstructive uterine malformation, 12 (4.3%) patients had an obstructive uterine malformation and 4 (1.4%) patients had uterine agenesia/hypoplasia. 209 (74.9%) patients had histologically confirmed endometriosis (peritoneal, ovarian or deep infiltrating) and 70 (25.1%) had no endometriosis. In 27 cases, deep infiltrating endometriosis (ENZIAN ABC) was detected additionally to peritoneal and ovarian endometriosis. Conclusion The study shows a high prevalence of endometriosis in women with uterine malformations. For this reason, endometriosis should always be specifically sought in uterine malformations. Keywords Uterus malformations · Endometriosis · Septate uterus · Unicornuate uterus · Bicornuate uterus
Introduction Endometriosis is a benign "proliferation" of endometrium with stroma, peristromal smooth muscles and nerves outside the uterine cavity. The pathogenesis is largely unknown. Endometriosis is probably a hereditary chronic disease with a hitherto unknown mode of inheritance. This disease has a polygenic and multifactorial mechanism of origin [7]. At reproductive age, endometriosis is one of the most common diseases [15]. In a study, adolescents in the age group 10–15 years and 15–20 years accounted for 0,05% and 1,93% of all endometriosis-affected women, respectively [8, 9]. However, up to 70% of young women and adolescents with chronic lower abdominal complaints, who do not respond to pain therapy, also suffer from endometriosis [17]. Reliable * Elvin Piriyev [email protected] 1
Department of Obstetrics and Gynecology, Academic Hospital Cologne, Weyertal University of Cologne, Cologne, Germany
data on the frequency of endometriosis are lacking, and the prevalence rates reported in the literature vary widely [9]. If we look at patients with lower abdominal pain, the frequency is 48–80%. In sterile patients, however, the frequency is 20–48% [18]. It is estimated that about 40,000 new cases with endometriosis occur in Germany every year [9, 15]. In Germany, approximately 20
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