Advanced Stage Endometriosis in Adolescents and Young Women

Study Objective: To describe the prevalence and characteristics of advanced stage endometriosis in adolescents and young women treated in a tertiary referral center. Design: Retrospective cohort. Setting: Tertiary referral center. Patients and Interventions: 86 adolescents and young women (≤22 y) who underwent surgery for endometriosis. The operative reports were reviewed for endometriosis stage, surgical findings, surgical procedures, and pathology. Main Outcome Measures: Endometriosis stage reported according to the revised American Fertility Society classification. Results: Early stage endometriosis (stage I or II) was found in 66 (76%) and advanced stage endometriosis (stage III or IV) in 20 (23%). The surgical findings in the 20 patients with advanced stage endometriosis included ovarian endometriomas in 14 cases, rectovaginal nodule in 1 case, and diaphragmatic and pulmonary endometriosis in 1 case. Women with advanced stage endometriosis were found to be slightly older at time of diagnosis than those with early stage disease (mean age 20.4 ± 1.4 y vs 18.7 ± 2.2 y respectively, P < .001). Conclusion: In adolescents and young women with endometriosis, advanced stage disease is not uncommon. The main presentation of advanced stage endometriosis in this age group is ovarian endometriomas rather than extensive peritoneal or adhesive disease.