Наружный генитальный эндометриоз: клинико-анамнестические факторы риска у женщин репродуктивного возраста

Abstract

Aim. To identify clinical and anamnestic risk factors for the development of external genital endometriosis. Design. Prospective cohort study. Materials and methods. As part of the study, 80 women of fertile age were examined: 54 patients with external genital endometriosis, confirmed by laparoscopy and histological examination (main group), and 26 women of the control group without external genital endometriosis. All participants were interviewed and examined in accordance with the applicable regulatory documents. Results. There were no significant differences in average age, level of education, body mass index, menstrual and reproductive functions, frequency of smoking and the structure of surgical interventions between two groups. However, the endometriosis patients were distinguished by a higher frequency of the digestive system diseases, namely chronic gastritis (p = 0.019); anemia (p = 0.174); benign breast dysplasia (p = 0.304); adhesions in the abdominal cavity (p = 0.095). On the contrary, the frequency of chronic inflammatory diseases of the uterine appendages was higher in the control group (p = 0.0000), which can be explained by the inclusion criteria in this group (planned laparoscopy due to infertility and/or chronic pelvic inflammatory disease). Patients of both groups are characterized by a low parity — on average, less than 1 birth per woman, which can partly be explained by the high frequency of infertility in the studied cohort: 38.8% of all examined, 24.1% of women with external genital endometriosis and 69.2% of women in the control group with a statistically significant predominance in the latter (p = 0.0001). Conclusion. Insufficient diagnostic effectiveness of existing methods of noninvasive verification of external genital endometriosis dictates the need to develop techniques based, among other things, on the consideration of clinical and anamnestic risk factors for the disease development. In addition, the elimination of the detected risk factors can contribute to the prevention of endometriosis development and recurrence after its treatment. Key words: external genital endometriosis, risk factors, noninvasive diagnostics.