Study objective

Early diagnosis and treatment of endometriosis in adolescents and young women is considered essential for improving their quality of life and for prevention of long-term complications. In adult women with endometriosis, significant delays in diagnosis and medical or surgical treatment have been described. Our study aimed to investigate the delay in diagnosis and treatment of adolescents and young women with suspected endometriosis.

Methods

A retrospective study of adolescents and young women (12–22 years-old) who were evaluated for suspected endometriosis at the endometriosis clinic in the Shamir medical center between January 2017 and December 2022. All patients were referred by their primary care gynecologists. The evaluation in the endometriosis clinic included targeted history, physical exam and a focused ultrasound survey for endometriosis (performed trans-abdominally in all cases, and trans-vaginally in sexually active women).

Results

Out of 400 women with suspected endometriosis evaluated in our endometriosis clinic during the study period, 68 were adolescents and young women <22 years old. Their mean age at time of evaluation for endometriosis was 18 ± 2.5 years, and the mean time-period from onset of symptoms to the endometriosis evaluation was 4.0 ± 2.9 years. Their most common symptoms were dysmenorrhea (in 61 cases, 89.7 %), followed by gastrointestinal symptoms (in 32 cases, 47.1 %). In 30 (44.1 %) cases, hormonal treatment was prescribed by the primary care gynecologist prior to their appointment in the endometriosis clinic. On comparison of patients with delay of <4 years (N = 31) versus ≥4 years (N = 37) from symptom onset to the endometriosis evaluation, patients with shorter duration of symptoms were more likely to decline any hormonal treatment for endometriosis while patients with longer duration of symptoms were more likely to accept the recommendation for hormonal treatment (16.2 % versus 0 %, p = 0.02, and 83.8 % versus 100 %, p = 0.03, respectively).

Conclusion

Adolescents and young women with suspected endometriosis may experience significant delays in diagnosis and medical care, similar to adult patients.

中文翻译：

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疑似子宫内膜异位症的青少年和年轻女性的延迟诊断和治疗

 学习目的

青少年和年轻女性子宫内膜异位症的早期诊断和治疗对于改善其生活质量和预防长期并发症至关重要。据报道，患有子宫内膜异位症的成年女性的诊断和药物或手术治疗明显延迟。我们的研究旨在调查疑似子宫内膜异位症的青少年和年轻女性的诊断和治疗延误情况。

 方法

这是一项回顾性研究，对象为 2017 年 1 月至 2022 年 12 月期间在沙米尔医疗中心子宫内膜异位症诊所接受疑似子宫内膜异位症评估的青少年和年轻女性（12-22 岁）。所有患者均由其初级保健妇科医生转诊。子宫内膜异位症诊所的评估包括有针对性的病史、体格检查和针对子宫内膜异位症的聚焦超声检查（所有病例均经腹部进行，性活跃女性经阴道进行）。

 结果

研究期间，在我们的子宫内膜异位症诊所评估了 400 名疑似子宫内膜异位症的女性，其中 68 名是青少年和年轻女性 <22 id=26>N = 31)，而从症状出现到子宫内膜异位症评估的时间≥4 年 ( N = 37)，症状持续时间较短的患者更有可能拒绝子宫内膜异位症的任何激素治疗，而症状持续时间较长的患者更有可能接受激素治疗的建议（16.2 % vs 0 %， p = 0.02，83.8 % vs 100 %） ， p = 0.03，分别）。

 结论

与成年患者类似，疑似子宫内膜异位症的青少年和年轻女性可能会经历诊断和医疗护理的严重延误。