The prevalence of surgically confirmed endometriosis is less than 25 percent among women undergoing hysterectomy for chronic pelvic pain, according to a study published in the June issue of Obstetrics & Gynecology.
Erika L. Mowers, M.D., from the University of Michigan in Ann Arbor, and colleagues conducted a retrospective cohort study involving 9,622 women who underwent laparoscopic or abdominal hysterectomy for benign indications. The prevalence of surgically confirmed endometriosis was determined by review of the operative report and surgical pathology for the entire cohort and for subgroups with or without chronic pelvic pain or endometriosis.
The researchers found that 15.2 percent of the patients undergoing hysterectomies had endometriosis at the time of hysterectomy. Fewer than one in four of the 3,768 women with a preoperative indication of chronic pelvic pain had endometriosis (21.4 percent). Many of those with preoperative indication of endometriosis did not actually have endometriosis at the time of hysterectomy (42.8 percent). Among women without preoperative indication of chronic pelvic pain or endometriosis, the rate of unexpected endometriosis was 8 percent. Among the women with a preoperative indication of chronic pelvic pain, endometriosis was more common in those with younger age, white race, and lower body mass index and for those who had previously failed another treatment.
"Fewer than 25 percent of women undergoing laparoscopic or abdominal hysterectomy for chronic pelvic pain have endometriosis at the time of surgery," the authors write.
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