Long term follow-up of inguinal endometriosis.

BACKGROUND: Inguinal endometriosis (IEM) is a rare extra pelvic endometriosis. Here, we study the clinical characteristics, management strategies, and long-term gynecological outcomes of IEM patients at Beijing Chaoyang Hospital. CASE PRESENTATION: Three patients presented with a total of four lesions (one on the left side, one on the right side, and one bilaterally). The diameters of the four lesions were 2 cm, 2 cm, 3.5 cm and 1.5 cm, respectively. Two patients were admitted with inguinal hernias. Two patients were admitted with endometrioses-one with ovarian endometriosis and one with pelvic endometriosis. The hernia sac was repaired concomitantly via excision of the round ligament in two patients. One patient underwent a concomitant laparoscopy for gynecologic evaluations, including an ablation to the peritoneal endometriosis, and resection of the left uterosacral ligament endometriosis and pelvic adhesiolysis. All lesions were located on the extraperitoneal portion of the round ligament and were diagnosed histologically. No recurrence was observed in the inguinal region. All patients diagnosed with adenomyosis were treated with medication alone without any complaints. CONCLUSIONS: Inguinal endometriosis can occur simultaneously with pelvic endometriosis. In most cases, a concomitant hernia sac appears together with groin endometriosis. Clinical management should be individualized and performed in tandem with general practitioners and obstetrics & gynecology experts. Pelvic disease, in particular, should be followed-up by a gynecologist.

[Correlative factors analysis and effect of pelvic pain associated with endometriosis after onservative surgery].

OBJECTIVE: To investigate prognosis of endometriosis and to determined correlative factors of pelvic pain associated with endometriosis after conservative surgery. METHODS: The clinical data in patients with pelvic pain related to endometriosis and underwent surgery treatment from January 2000 to September 2009 in Beijing Chaoyang Hospital were collected and sorted, then the patients were followed up. The data were analyzed by statistical software SPSS 13.0 for windows. RESULTS: A total of 332 patients with endometriomas were underwent conservative surgery, 281(84.6%, 281/332)cases of them relieved pelvic pain. The univariate analysis showed that the effects were signficantly with age, Douglas pouch reconstruction, postoperative medical therapy, presacral neurectomy (PSN)and combined adenomyosis (all P < 0.05). The multivariate analysis also showed that age (OR = 0.946, P < 0.01), Douglas pouch reconstruction (OR = 0.208, P < 0.01), postoperative medical therapy (OR = 0.504, P < 0.01), PSN (OR = 0.121, P < 0.05) and combined with adenomyosis (OR = 2.528, P < 0.01) were also the correlative factors to prognosis. CONCLUSION: The protective factors for prognosis of pelvic pain associated with endometriosis included age, Douglas pouch reconstruction, postoperative medical therapy and PSN, while the risk factor was combined with uterine adenomyosis.