O-028 Genital tract infection and pelvic surgery contribute to the development of endometriosis

Abstract

Abstract Study question Was the incidence of endometriosis in women with a recent history of genital infection, pelvic surgery, or both increased? Summary answer The pelvic inflammation resulting from genital infection and pelvic surgical injury may play a role in developing endometriosis. What is known already Endometriosis is a multifactorial disease, and inflammation is considered a core pathology. Inflammation occurs due to pathogenic infection and tissue injury, and genital tract infection and surgical injury can be inducers for pelvic inflammation in endometriosis. Study design, size, duration A retrospective cohort study using the Korean National Health Insurance Service -National Sample Cohort I (KNHIS-SC I) from 2002-2013 (N = 1,025,340) was performed. Participants/materials, setting, methods 20- to 49-year-old women diagnosed with genital tract infections (GTI) or who underwent pelvic surgeries between 2002 and 2008 were collected and followed up for five years. A total of 30,336 women were diagnosed with GTI, 2,894 women underwent pelvic surgery, and 788 women with GTI and pelvic surgery were enrolled in each study. The comparison groups matched sociodemographic factors for each group were collected. The incidence of endometriosis in each group was analyzed. Main results and the role of chance The incidence of endometriosis per 1,000 person-year was 5.37, 5.17, and 20.81 in each case group and was significantly higher than in each comparison group. A recent history of GTI increased an adjusted hazard ratio (aHR) of 2.29 (1.99-2.63, 95% confidence interval) for the development of endometriosis. The aHRs of pelvic surgery history and the history of both GTI and pelvic surgery were 2.10 and 7.82, respectively. Limitations, reasons for caution The diagnosis and treatment codes registered on the NHIS data are used to claim HIRA NHI benefits, which may differ from the diagnosis or treatment performed in practice and it does not contain the used diagnostic method, disease severity, and the disease led to pelvic surgery were not specified. Wider implications of the findings Active treatment of genital infections and careful surgical procedures to minimize tissue injury may reduce the incidence of pelvic endometriosis. Trial registration number Not Applicable