Recurrence of endometriosis in women with abnormal uterine contractility

Abstract

Objective: To establish the recurrence rate of endometriosis in patients with abnormal uterine contractility (UC). Design: Prospective randomized controlled study. Materials and Methods: Forty-six women who had laparoscopy for endometriosis (Stage III–IV ASRM revised classification-Fertil Steril 1997;67,5: 8–19) were selected in order to obtain a study group (group I) with abnormal UCs (n 23) (Human Reprod 2001;16,12: 2676–9 -Fertil Steril 2002;77,6: 1156–61) and a control group (group II) with normal UCs at the menses (n 23) (Human Reprod 2000;15 Suppl 1: 81–9). All patients were surgically treated for endometriosis and studied as for their UCs by Ultrasound (US) before and three months after surgery.The recurrence rate was detected by a second look laparoscopy on those patients who had severe and unacceptable pelvic pain/dysmenorrehea (PP/D) within two years from the previous surgery. Results: Thirty-six women (78%) had recurrence of PP/D and 28 (78%) of those underwent a 2nd laparoscopy (group I n 22-group II n 6).Endometriosis was found in 19 of 22 group I (86%) and 2 of 6 group II (33%) women. The most common abnormal UCs observed in the study group I was the high frequency of UCs (66%) and the fundus to cervix displacementof the UCs themselves (85%).We found a significant correlation between the frequency of UCs and the recurrence of endometriosis (p<0.002) and between the pattern of UCs“fundus to cervix” and the recurrence of this disease (p<0.001). Conclusion: Patients with high frequency patterns of UCs and dominant fundus to cervix displacement show a higher risk of recurrence of endometriosis.