Endometriosis in Adolescents with Obstructive Anomalies of the Reproductive Tract

Background: This study aimed to assess the prevalence and course of endometriosis in adolescents with obstructive Mullerian anomalies. Methods: The study group involved 50 adolescents undergoing surgeries (median age 13.5 (range 11.1-18.5)) for rare obstructive malformations of the genital tract: 15 girls had anomalies associated with cryptomenorrhea and 35 were menstruating. The median follow-up period was 2.4 (ranging from 0.1 to 9.5) years. Results: We diagnosed endometriosis in 23 of the 50 subjects (46%), including 10 of the 23 patients (43.5%) with obstructed hemivagina ipsilateral renal anomaly syndrome (OHVIRAS), six of eight patients (75%) with a unicornuate uterus with a non-communicating functional horn, two of three patients (66.7%) with distal vaginal aplasia, and five of five patients (100%) with cervicovaginal aplasia. Persistent dysmenorrhea, following treatment, affected 14 of the 50 adolescents (28%), including 8 of the 17 subjects (47.1%) diagnosed with endometriosis at the time of surgical correction and six adolescents diagnosed with endometriosis during the follow-up. Conclusions: Endometriosis affects about half of young adolescents undergoing surgical treatment of obstructive Mullerian anomalies after menarche. The incidence of endometriosis is highest in girls with cervical aplasia. The risk of developing endometriosis decreases after surgical correction of obstruction but is still significant in patients with uterine anomalies.

Automated summary

This study aimed to assess the prevalence and course of endometriosis in adolescents with obstructive Mullerian anomalies. The study found that 46% of the 50 adolescents who underwent surgical treatment were diagnosed with endometriosis. Persistent dysmenorrhea affected 28% of the adolescents, with 47.1% diagnosed with endometriosis at the time of surgical correction. Conclusion: About half of the young adolescents who undergo surgical treatment for obstructive Mullerian anomalies after menarche develop endometriosis, with the highest incidence in girls with cervical aplasia. Surgical correction can reduce the risk of developing endometriosis, but significant risk still exists in patients with uterine anomalies.