Problem of endometriosis diagnosis within the framework of systemic disease

Aim. To study the clinical cases of extragenital endometriosis, reveal the key moments of diagnosis and study the risk factors for the development of this disease.

Materials and methods. The study was carried out on the basis of gynecological hospitals of Perm in 2000-2015. Retrospective analysis of case histories of 22 patients with extragenital endometriosis of different localization was performed. Prospective analysis by means of questionnaire survey of 20 patients, operated for extragenital endometriosis, was used to assess the quality of life, working ability, prognosis regarding recovery.

Results. A mean age of the examined women was 35 ± 3.5 years. Genital endometriosis was diagnosed in 81.8 % of patients, burdened obstetric-gynecological anamnesis – in 86.3 %. The main patients’ complaints were the following: dysmenorrhea and hyperpolymenorrhea (90.9 %), sterility (77.3 %), pain syndrome, dysfunction and hemorrhagic discharges from the damaged organs, cyclically coinciding with menstrual cycle. All patients (100 %) underwent surgical treatment of different forms of extragenital endometriosis, and by the results of histological study of surgical material, stromal and epithelial endometrial cells were detected. Prospectively: prognosis regarding life and working ability was beneficial, as for recovery – doubtful in 55 % of cases, recurrences – 45 % both in previously damaged and other organs.

Conclusions. The presented clinical cases demonstrate that endometriosis is an interdisciplinary problem, which needs complex approach to diagnosis and management. Thoroughly collected anamnesis, including obstetric and gynecological as well as questioning, performed by other specialists is required. Patients with the revealed extragenital forms of endometriosis should be treated together with obstetricians and gynecologists.