Clinical and anamnestic characteristics of isolated and combined genital endometriosis
Ponomareva T.A., Altukhova O.B., Ponomarenko I.V., Churnosov M.I.
Objective: To evaluate clinical and anamnestic data of patients with isolated and combined genital endometriosis.
Materials and methods: This study was conducted at the perinatal center of St. Ioasaph Belgorod Regional Clinical Hospital and included 395 patients with genital endometriosis, diagnosed through morphological examination after surgical treatment. The patients were divided into four groups based on the presence or absence of concomitant proliferative diseases of the female reproductive system. Group 1 consisted of patients with isolated endometriosis (n=103); group 2 included patients with endometriosis and endometrial hyperplastic processes (EHP) (n=183); group 3 consisted of patients with endometriosis and uterine myoma (n=207); and group 4 included patients with endometriosis, uterine myoma, and EHP (n=98). Complaints and clinical and anamnestic data were collected through interviews and questioning, followed by a comparative analysis of the characteristics of the studied patient groups.
Results: The study findings indicated that among patients with isolated genital endometriosis, women of early reproductive age predominated, with a median age of 31 (27; 37.5) years], lower body mass index (BMI) (23.84 [20.89; 27.77] kg/m2), and significantly earlier onset of sexual activity (between ages 14 and 18) in 59/103 (57.28%) patients. In contrast, among patients with a combination of endometriosis and proliferative diseases of the uterus, women of late reproductive age were more common, with median ages of 42 (36; 48) years in group 2, 44 (37; 49) years in group 3, and 45 (40; 49) years in group 4 with a significantly higher BMI [median BMI among patients in group 2 was 27.29 (22.85; 30.48) kg/m2, in group 3 – 27.55 (24.03; 31.24) kg/m2, in group 4 – 28.22 (24.03; 31.86) kg/m2]. This cohort of patients had a higher number of pregnancies (the median in these groups was 3 (1; 4), 3 (1; 5) and 3 (2; 4), respectively), births (the median in these groups was 1 (0; 2), 1 (1; 2) and
1 (1; 2), respectively) and induced abortions (the median in all groups of patients with combined genital endometriosis was 1 (0; 2)).
Conclusion: Patients with isolated and combined genital endometriosis exhibited distinct clinical and anamnestic features that should be considered in clinical management.
Authors' contributions: Ponomareva T.A. – literature search and analysis, data summarization, drafting of the manuscript; Ponomarenko I.V. – editing of the manuscript; Altukhova O.B. – conception and plan of the study; Churnosov M.I. – manuscript revision, final editing of the manuscript.
Conflicts of interest: The authors have no conflicts of interest to declare.
Funding: There was no funding for this study.
Ethical Approval: The study was reviewed and approved by the Research Ethics Committee of the St. Ioasaph Belgorod Regional Clinical Hospital.
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Authors' Data Sharing Statement: The data supporting the findings of this study are available upon request from the corresponding author after approval from the principal investigator.
For citation: Ponomareva T.A., Altukhova O.B., Ponomarenko I.V., Churnosov M.I.
Clinical and anamnestic characteristics of isolated and combined genital endometriosis.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2025; (3): 84-91 (in Russian)
https://dx.doi.org/10.18565/aig.2024.286
Keywords
clinical picture
endometriosis
endometrial hyperplasia
uterine myoma
References
- Адамян Л.В., Андреева Е.Н. Эндометриоз и его глобальное влияние на организм женщины. Проблемы репродукции. 2022; 28(1): 54 64. [Adamyan L.V., Andreeva E.N. Endometriosis and its global impact on a woman’s body. Russian Journal of Human Reproduction. 2022; 28(1): 54 64. (in Russian)]. https://dx.doi.org/10.17116/repro20222801154.
- Thomas E.J. The relevance of asymptomatic endometriosis. Hum. Reprod. 1996; 11(Suppl. 3): 103-9. https://dx.doi.org/10.1093/humrep/11.suppl_3.103.
- Bulletti C., Coccia M.E., Battistoni S., Borini A. Endometriosis and infertility. J. Assist. Reprod. Genet. 2010; 27(8): 441-7. https://dx.doi.org/10.1007/s10815-010-9436-1.
- Moradi Y., Shams-Beyranvand M., Khateri S., Gharahjeh S., Tehrani S., Varse F. et al. A systematic review on the prevalence of endometriosis in women. Indian J. Med. Res. 2021; 154(3): 446-54. https://dx.doi.org/10.4103/ijmr.IJMR_817_18.
- Пономарева Т.А., Алтухова О.Б., Пономаренко И.В., Чурносов М.И. Современные представления о механизмах развития и факторах риска эндометриоза. Акушерство и гинекология. 2024; 7: 12-20. [Ponomareva T.A., Altukhova O.B., Ponomarenko I.V., Churnosov M.I. Novel concepts in the pathogenesis and risk factors of endometriosis. Obstetrics and Gynecology. 2024; (7): 12-20. (in Russian)]. https://dx.doi.org/10.18565/aig.2024.110.
- Пономарева Т.А., Алтухова О.Б., Пономаренко И.В., Чурносов М.И. Роль генетических факторов в формировании эндометриоидных поражений. Акушерство, гинекология и репродукция. 2023; 17(4): 443-54. [Ponomareva T.A., Altukhova O.B., Ponomarenko I.V., Churnosov M.I. The role of genetic factors in developing endometrioid lesions. Obstetrics, Gynecology and Reproduction. 2023; 17(4): 443-54. (in Russian)]. https://dx.doi.org/10.17749/2313-7347/ob.gyn.rep.2023.434.
- Андреев А.Е., Клейменова Т.С., Дробинцева А.О., Полякова В.О., Кветной И.М. Сигнальные молекулы, вовлеченные в образование новых нервных окончаний при эндометриозе (обзор). Научные результаты биомедицинских исследований. 2019; 5(1): 94-107. [Andreev A.E., Kleimenova T.S., Drobintseva A.O., Polyakova V.O., Kvetnoi I.M. Signal molecules involved in the formation of new nerve endings in endometriosis (review.) Research Results in Biomedicine. 2019; 5(1): 94-107. (in Russian)]. https://dx.doi.org/10.18413/2313-8955-2019-5-1-0-7.
- Радзинский В.Е., Алтухова О.Б. Молекулярно-генетические детерминанты бесплодия при генитальном эндометриозе. Научные результаты биомедицинских исследований. 2018; 4(3): 28-37. [Radzinsky V.E., Altuchova O.B. Molecular-genetic determinants of infertility in genital endometryosis. Research Results in Biomedicine. 2018; 4(3): 28-37. (in Russian)]. https://dx.doi.org/10.18413/2313-8955-2018-4-3-0-3.
- Пономаренко И.В., Полоников А.В., Верзилина И.Н., Чурносов М.И. Молекулярно-генетические детерминанты развития эндометриоза. Вопросы гинекологии, акушерства и перинатологии. 2019; 18(1): 82-6. [Ponomarenko I.V., Polonikov A.V., Verzilina I.N., Churnosov M.I. Molecular-genetic determinants of the development of endometriosis. Gynecology, Obstetrics and Perinatology. 2019; 18(1): 82-6. (in Russian)]. https://dx.doi.org/10.20953/1726-1678-2019-1-82-86.
- Lamceva J., Uljanovs R., Strumfa I. The main theories on the pathogenesis of endometriosis. Int. J. Mol. Sci. 2023; 24(5): 4254. https://dx.doi.org/10.3390/ijms24054254.
- Wang P.H., Yang S.T., Chang W.H., Liu C.H., Lee F.K., Lee W.L. Endometriosis: part I. Basic concept. Taiwan. J. Obstet. Gynecol. 2022; 61(6): 927-34. https://dx.doi.org/10.1016/j.tjog.2022.08.002.
- Щукина Н.А., Буянова С.Н., Бабунашвили Е.Л., Тихомирова Е.В., Земскова Н.Ю., Глебов Т.А. Современные подходы к медикаментозному лечению пациенток с сочетанными пролиферативными заболеваниями матки. Российский вестник акушера-гинеколога. 2022; 22(6): 102-8. [Shchukina N.A., Buyanova S.N., Babunashvili E.L., Tikhomirova E.V., Zemskova N.Yu., Glebov T.A. Current approaches to drug therapy in patients with concomitant proliferative uterine diseases. Russian Bulletin of Obstetrician-Gynecologist. 2022; 22(6): 102-8. (in Russian)]. https://dx.doi.org/10.17116/rosakush202222061102.
- Реброва О.Ю. Статистический анализ медицинских данных. Применение пакета прикладных программ STATISTICA. М.: МедиаСфера; 2006. 312c. [Rebrova O.Yu. Statistical analysis of medical data. Application of the STATISTICA software package. Moscow: MediaSfera; 2006. 312p. (in Russian)].
- Кудрина Е.А., Жолобова М.Н., Масякина А.В. Современные аспекты патогенеза и лечения гиперплазии эндометрия, миомы матки и аденомиоза. Архив акушерства и гинекологии им. В.Ф. Снегирева. 2016; 3(3): 130-5. [Kudrina E.A., Zholobova M.N., Masyakina A.V. Modern aspects of pathogenesis and treatment of endometrial hyperplasia, uterine fibroids and adenomyosis. V.F. Snegirev Archives of Obstetrics and Gynecology. 2016; 3(3): 130-5. (in Russian)]. https://dx.doi.org/10.18821/2313-8726-2016-3-3-130-135.
- Wu X., Zheng Y. Clinicopathological features and prognostic factors for uterine myoma. Pak. J. Med. Sci. 2022; 38(6): 1580-3. https://dx.doi.org/10.12669/pjms.38.6.5455.
- Crump J., Suker A., White L. Endometriosis: a review of recent evidence and guidelines. Aust. J. Gen. Pract. 2024; 53(1-2): 11-8. https://dx.doi.org/10.31128/AJGP/04-23-6805.
- Qu Y., Chen L., Guo S., Liu Y., Wu H. Genetic liability to multiple factors and uterine leiomyoma risk: a Mendelian randomization study. Front. Endocrinol. 2023; 14: 1133260. https://dx.doi.org/10.3389/fendo.2023.1133260.
- Ponomarenko M.S., Reshetnikov E.A., Churnosova M.M. Reshetnikova Yu.N., Churnosov V.I., Ponomarenko I.V. Comorbidity and syntropy of benign proliferative diseases of the female reproductive system: non-genetic, genetic, and epigenetic factors (review). Research Results in Biomedicine. 2023; 9(4): 544-56. https://dx.doi.org/10.18413/2658- 6533-2023-9-4-0-9.
- Пономаренко И.В., Полоников А.В., Чурносов М.И. Молекулярные механизмы и факторы риска развития эндометриоза. Акушерство и гинекология. 2019; 3: 26-31. [Ponomarenko I.V., Polonikov A.V., Churnosov M.I. Molecular mechanisms of and risk factors for endometriosis. Obstetrics and Gynecology. 2019; (3): 26-31. (in Russian)]. https://dx.doi.org/10.18565/aig.2019.3.26-31.
- Ennab F., Atiomo W. Obesity and female infertility. Best Pract. Res. Clin. Obstet. Gynaecol. 2023; 89: 102336. https://dx.doi.org/10.1016/j.bpobgyn.2023.102336.
- Pantelis A., Machairiotis N., Lapatsanis D.P. The formidable yet unresolved interplay between endometriosis and obesity. ScientificWorldJournal. 2021; 2021: 6653677. https://dx.doi.org/10.1155/2021/6653677.
- Venkatesh S.S., Ferreira T., Benonisdottir S., Rahmioglu N., Becker C.M., Granne I. et al. Obesity and risk of female reproductive conditions: a Mendelian randomisation study. PLoS Med. 2022; 19(2): e1003679. https://dx.doi.org/10.1371/journal.pmed.1003679.
- Головченко И.О. Генетические детерминанты уровня половых гормонов у больных эндометриозом. Научные результаты биомедицинских исследований. 2023; 9(1): 5-21. [Golovchenko I.O. Genetic determinants of sex hormone levels in endometriosis patients. Research Results in Biomedicine. 2023; 9(1): 5-21. (in Russian)]. https://dx.doi.org/10.18413/2658-6533-2023-9-1-0-1.
- Golovchenko I., Aizikovich B., Golovchenko O., Reshetnikov E., Churnosova M., Aristova I. et al. Sex hormone candidate gene polymorphisms are associated with endometriosis. Int. J. Mol. Sci. 2022; 23(22): 13691. https://dx.doi.org/10.3390/ijms232213691.
- Петров А.Ю., Узбекова Л.Д., Середа Е.В. Ближайшие и отдаленные последствия артифициального прерывания беременности. Международный научно-исследовательский журнал. 2022; 6-2: 131-4. [Petrov A.Yu., Uzbekova L.D., Sereda E.V. Immediate and long-term consequences of an artifactual termination of pregnancy. International Research Journal. 2022; (6-2): 131-4. (in Russian)]. https://dx.doi.org/10.23670/IRJ.2022.120.6.055.
- Могильная Г.М., Куценко И.И., Симовоник А.Н. Переходная зона матки и аденомиоз. Журнал анатомии и гистопатологии. 2018; 7(1): 108-17. [Mogil'naya G.M., Kutsenko I.I., Simovonik A.N. The junctional zone of the uterus and adenomyosis. Journal of Anatomy and Histopathology. 2018; 7(1): 108-17. (in Russian)]. https://dx.doi.org/10.18499/2225-7357-2018-7-1-108-117.
- Van Gerwen O.T., Muzny C.A., Marrazzo J.M. Sexually transmitted infections and female reproductive health. Nat. Microbiol. 2022; 7(8): 1116-26. https://dx.doi.org/10.1038/s41564-022-01177-x.
- Filip L., Duică, F., Prădatu A., Crețoiu D., Suciu N., Crețoiu S.M. et al. Endometriosis associated infertility: a critical review and analysis on etiopathogenesis and therapeutic approaches. Medicina (Kaunas). 2020; 56(9): 460. https://dx.doi.org/10.3390/medicina56090460.
Received 11.11.2024
Accepted 26.02.2025
About the Authors
Tatiana A. Ponomareva, PhD student at the Department of Medical and Biological Disciplines, Belgorod National Research University, 85 Pobedy str., 308007, Belgorod, Russia; Obstetrician-Gynecologist, St. Joasaph Belgorod Regional Clinical Hospital, 8/9 Nekrasov str., 308015, Belgorod, Russia, rybaarbusova@icloud.com,https://orcid.org/0009-0007-8533-9319
Oxana B. Altukhova, Dr. Med. Sci., Associate Professor, Head of the Department of Obstetrics and Gynecology, Belgorod National Research University,
85 Pobedy str., 308007, Belgorod, Russia; Head of Gynecological Department, St. Joasaph Belgorod Regional Clinical Hospital, 8/9 Nekrasov str., 308015, Belgorod, Russia, altuhova_o@bsuedu.ru, https://orcid.org/0000-0003-4674-8797
Irina V. Ponomarenko, Dr. Med. Sci., Associate Professor at the Department of Medical and Biological Disciplines, Belgorod National Research University,
85 Pobedy str., 308007, Belgorod, Russia, ponomarenko_i@bsuedu.ru, https://orcid.org/0000-0002-5652-0166
Mikhail I. Churnosov, Dr. Med. Sci., Professor, Head of the Department of Medical and Biological Disciplines, Belgorod National Research University,
85 Pobedy str., 308007, Belgorod, Russia, churnosov@bsuedu.ru, https://orcid.org/ 0000-0003-1254-6134
Corresponding author: Tatiana A. Ponomareva, rybaarbusova@icloud.com
Similar Articles
