Wednesday 7 September 2005
Recurring endometriosis
Issue 18: 5 Sep 2005
Source: European Journal of Obstetrics & Gynecology and Reproductive Biology 2005; 121: 216-9
“The recurrence rate of clinically detectable endometriosis tends to be higher in older women with advanced stages of the disease, and lower in women with infertility,” researchers have concluded.
The findings followed a prospective multicenter study involving specialists and patients at 12 gynecology departments in Italy. The aim was to determine the recurrence rate of clinically detectable endometriosis within 2 years of the initial diagnosis, and to identify factors associated with recurrence.
A total of 311 women who had a laparoscopically confirmed first diagnosis of endometriosis during the period January to June 1998 entered the study. The women, with a median age of 36 years, were treated according to the standard care of each center, and then followed up once a year for 2 years with a clinical examination, ultrasound pelvic examination, and CA125 test, unless they had become pregnant. Laparoscopy was performed if clinically indicated.
Overall, a recurrence of endometriosis occurred in 20 of the women in the 2-year period. Of these, 17 cases were confirmed by laparoscopy, and the remaining three diagnoses were based on rising CA125 levels and ultrasound findings (of endometriomas) alone.
The recurrence rate was found to be 4.6 percent at 1 year, and 9.0 percent at 2 years after diagnosis. These rates were 3.3 percent and 6.3 percent respectively when considering only the 17 surgically confirmed cases of recurrence.
Stage, age, and infertility
The researchers found a statistically significant effect of disease stage on the recurrence rate. The 2-year recurrence rate was 5.7 percent among women with endometriosis stage I or II, and 14.4 percent among with stage III or IV disease.
There was also a trend towards an increasing chance of recurrence with increasing age (4.6 percent among women aged 20-30, 13.1 percent among women over 30), and also a lower recurrence rate among women with infertility compared with other indications for diagnosis, such as pelvic pain or ovarian cysts (4.3 percent versus 9.0 percent and 11.3 percent respectively). However, the differences were not statistically significant.
http://www.orgyn.com/en/webzine/2005/Issue_18/Recurring_endometrio.asp 
Recurring endometriosis 
