Absence of dysmenorrhea, cyclic abdominal pain up risk of abdominal wall endometriosis
Cyclic localized abdominal pain, previous laparotomy and absence of dysmenorrhea are significant risk factors for abdominal wall endometriosis, a new study shows.
Compared with 68 controls (mean age 33.5±8.8 years), significantly more women with abdominal wall endometriosis (n=34; mean age 35.2±5.9 years) had abdominal pain (100 vs 26.5 percent; p<0.001) and a history of laparotomy (94.1 vs 14.7 percent; p<0.001).
On the other hand, significantly less women with abdominal wall endometriosis had dysmenorrhea compared with controls (11.8 vs 39.7 percent; p=0.004).
Multivariable analysis showed that cyclic abdominal pain (adjusted odds ratio [OR], 12.46; 95 percent CI, 2.07 to 125.09), absence of dysmenorrhea (adjusted OR, 11.31; 1.51 to 132.56) and previous laparotomy (adjusted OR, 61.9; 12.77 to 533.79) were all associated with abdominal wall endometriosis.
Together, the area under the receiver operating characteristic curve was 0.94 (0.87 to 0.98).
Baseline parity (two vs zero; p<0.001) and body mass index (29.2±6.6 vs 26.4±6.7 kg/m2; p=0.02) were higher, and caesarean delivery (88.2 vs 10.3 percent; p<0.001) and gynaecologic surgeries (zero to 15 vs zero to seven percent; p=0.003) were more common in the abdominal wall endometriosis patients than in controls.
Mean symptom duration was 38.6±31.3 months. None of the patients developed pelvic endometriosis nor had complications after surgery. Repeat surgery was performed on 5.9 percent (n=2) of patients.
Investigators recruited women receiving surgery for endometriosis at the Mayo Clinic between January 1, 2000 and December 31, 2013. The Students t test, Wilcoxon rank sum or Fisher’s exact test were used to compare variables between cases and controls.