Skip to main content
Top
Published in: BMC Women's Health 1/2021

Open Access 01-12-2021 | Infertility | Research

Prevalence of endometriosis in women undergoing laparoscopic surgery for various gynaecological indications at a Jordanian referral centre: gaining insight into the epidemiology of an important women's health problem

Authors: Nadia Muhaidat, Shawqi Saleh, Kamil Fram, Mohammed Nabhan, Nadia Almahallawi, Saif Aldeen Alryalat, Mutasem Elfalah, Mohammed Elfalah

Published in: BMC Women's Health | Issue 1/2021

Login to get access

Abstract

Background

Endometriosis is a considerable health challenge for women of reproductive age. Information about its prevalence in the Jordanian population is sparse. The objective of this research was to evaluate the presence of endometriosis in gynaecological patients undergoing laparoscopic surgery for various indications and to correlate the finding of endometriosis with variables, including patient demographics, obstetric history, type, and indication of laparoscopic procedure.

Methods

A retrospective cohort study involving 460 women who underwent different laparoscopic procedures for a variety of indications was conducted in the Department of Obstetrics and Gynaecology in Jordan University Hospital, a tertiary referral hospital in Jordan, between January 2015 and September 2020.

Results

The prevalence of endometriosis in this patient group was higher than that of the general population (13.7% vs. 2.5%), and the mean age at diagnosis (31.9 years) was younger than the general population's age of peak incidence (35–45 years). It was significantly higher in women with lower numbers of pregnancies (p = 0.01) and a lower number of Caesarean sections (p = 0.05) and in those where the indication for surgery was related to decreased fertility or pelvic pain (p = 0.02). Women with high parity or where the surgery's indication suggested normal fertility, such as family planning, were less likely to have endometriosis.

Conclusion

To our knowledge, this is the first Jordanian study to assess the prevalence of endometriosis in women undergoing gynaecological laparoscopy. This study suggests that the epidemiology of endometriosis in this region follows similar trends to what has been previously documented in international literature, while emphasizing the need for further research into this important women's health issue in this part of the world.
Literature
1.
go back to reference Al-Jefout M. Laparoscopy for diagnosis and treatment of endometriosis. Adv Gynecol Endosc. 2011;23:183. Al-Jefout M. Laparoscopy for diagnosis and treatment of endometriosis. Adv Gynecol Endosc. 2011;23:183.
3.
go back to reference Eskenazi B, et al. Epidemiology of endometriosis. Obstet Gynecol Clin N Am. 1997;24(2):235–580.CrossRef Eskenazi B, et al. Epidemiology of endometriosis. Obstet Gynecol Clin N Am. 1997;24(2):235–580.CrossRef
4.
go back to reference Fuldeore MJ, Soliman AM. Prevalence and symptomatic burden of diagnosed endometriosis in the United States: national estimates from a cross-sectional survey of 59,411 women. Gynecol Obst Investig. 2017;82(5):453–61.CrossRef Fuldeore MJ, Soliman AM. Prevalence and symptomatic burden of diagnosed endometriosis in the United States: national estimates from a cross-sectional survey of 59,411 women. Gynecol Obst Investig. 2017;82(5):453–61.CrossRef
5.
go back to reference Morassutto C, Monasta L, Ricci G, Barbone F, Ronfani L. Incidence and estimated prevalence of endometriosis and adenomyosis in Northeast Italy: a data linkage study. PLoS ONE. 2016;11(4):e0154227.CrossRef Morassutto C, Monasta L, Ricci G, Barbone F, Ronfani L. Incidence and estimated prevalence of endometriosis and adenomyosis in Northeast Italy: a data linkage study. PLoS ONE. 2016;11(4):e0154227.CrossRef
6.
go back to reference Al-Jefout M, Nesheiwat A, Odainat B, Sami R, Alnawaiseh N. Questionnaire-based prevalence of endometriosis and its symptoms in Jordanian women. Biomed Pharmacol J. 2017;10(2):699–706.CrossRef Al-Jefout M, Nesheiwat A, Odainat B, Sami R, Alnawaiseh N. Questionnaire-based prevalence of endometriosis and its symptoms in Jordanian women. Biomed Pharmacol J. 2017;10(2):699–706.CrossRef
7.
go back to reference Al-Jefout M, Alnawaiseh N, Yaghi S, Alqaisi A. Prevalence of endometriosis and its symptoms among young Jordanian women with chronic pelvic pain refractory to conventional therapy. J Obst Gynaecol Can. 2018;40(2):165–70.CrossRef Al-Jefout M, Alnawaiseh N, Yaghi S, Alqaisi A. Prevalence of endometriosis and its symptoms among young Jordanian women with chronic pelvic pain refractory to conventional therapy. J Obst Gynaecol Can. 2018;40(2):165–70.CrossRef
8.
go back to reference Janssen EB, Rijkers AC, Hoppenbrouwers K, Meuleman C, d’Hooghe TM. Prevalence of endometriosis diagnosed by laparoscopy in adolescents with dysmenorrhea or chronic pelvic pain: a systematic review. Hum Reprod Update. 2013;19(5):570–82.CrossRef Janssen EB, Rijkers AC, Hoppenbrouwers K, Meuleman C, d’Hooghe TM. Prevalence of endometriosis diagnosed by laparoscopy in adolescents with dysmenorrhea or chronic pelvic pain: a systematic review. Hum Reprod Update. 2013;19(5):570–82.CrossRef
9.
go back to reference Nnoaham KE, Hummelshoj L, Webster P, d’Hooghe T, de Cicco Nardone F, de Cicco Nardone C, Jenkinson C, Kennedy SH, Zondervan KT, Study WE. Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril. 2011;96(2):366–73.CrossRef Nnoaham KE, Hummelshoj L, Webster P, d’Hooghe T, de Cicco Nardone F, de Cicco Nardone C, Jenkinson C, Kennedy SH, Zondervan KT, Study WE. Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Fertil Steril. 2011;96(2):366–73.CrossRef
10.
go back to reference Bulletti C, Coccia ME, Battistoni S, Borini A. Endometriosis and infertility. J Assist Reprod Genet. 2010;27(8):441–7.CrossRef Bulletti C, Coccia ME, Battistoni S, Borini A. Endometriosis and infertility. J Assist Reprod Genet. 2010;27(8):441–7.CrossRef
12.
go back to reference Shafrir AL, Farland LV, Shah DK, Harris HR, Kvaskoff M, Zondervan K, Missmer SA. Risk for and consequences of endometriosis: a critical epidemiologic review. Best Pract Res Clin Obstet Gynaecol. 2018;1(51):1–5.CrossRef Shafrir AL, Farland LV, Shah DK, Harris HR, Kvaskoff M, Zondervan K, Missmer SA. Risk for and consequences of endometriosis: a critical epidemiologic review. Best Pract Res Clin Obstet Gynaecol. 2018;1(51):1–5.CrossRef
13.
go back to reference Kennedy S, Bergqvist A, Chapron C, Dhooghe T, Dunselman G, Greb R, Hummelshoj L, Prentice A, Saridogan E. ESHRE guideline for the diagnosis and treatment of endometriosis. Hum Reprod. 2005;20(10):2698–704.CrossRef Kennedy S, Bergqvist A, Chapron C, Dhooghe T, Dunselman G, Greb R, Hummelshoj L, Prentice A, Saridogan E. ESHRE guideline for the diagnosis and treatment of endometriosis. Hum Reprod. 2005;20(10):2698–704.CrossRef
14.
go back to reference Hsu AL, et al. Invasive and noninvasive methods for the diagnosis of endometriosis. Clin Obstet Gynecol. 2010;53(2):413–9.CrossRef Hsu AL, et al. Invasive and noninvasive methods for the diagnosis of endometriosis. Clin Obstet Gynecol. 2010;53(2):413–9.CrossRef
15.
go back to reference Laufer MR, Goitein L, Bush M, Cramer DW, Emans SJ. Prevalence of endometriosis in adolescent girls with chronic pelvic pain not responding to conventional therapy. J Pediatr Adolesc Gynecol. 1997;10(4):199–202.CrossRef Laufer MR, Goitein L, Bush M, Cramer DW, Emans SJ. Prevalence of endometriosis in adolescent girls with chronic pelvic pain not responding to conventional therapy. J Pediatr Adolesc Gynecol. 1997;10(4):199–202.CrossRef
16.
go back to reference Koninckx PR, Ussia A, Keckstein J, Wattiez A, Adamyan L. Epidemiology of subtle, typical, cystic, and deep endometriosis: a systematic review. Gynecol Surg. 2016;13(4):457–67.CrossRef Koninckx PR, Ussia A, Keckstein J, Wattiez A, Adamyan L. Epidemiology of subtle, typical, cystic, and deep endometriosis: a systematic review. Gynecol Surg. 2016;13(4):457–67.CrossRef
17.
go back to reference Guo SW, Wang Y. The prevalence of endometriosis in women with chronic pelvic pain. Gynecol Obstet Investig. 2006;62(3):121–30.CrossRef Guo SW, Wang Y. The prevalence of endometriosis in women with chronic pelvic pain. Gynecol Obstet Investig. 2006;62(3):121–30.CrossRef
18.
go back to reference Hager M, Wenzl R, Riesenhuber S, Marschalek J, Kuessel L, Mayrhofer D, Ristl R, Kurz C, Ott J. The prevalence of incidental endometriosis in women undergoing laparoscopic ovarian drilling for clomiphene-resistant polycystic ovary syndrome: a retrospective cohort study and meta-analysis. J Clin Med. 2019;8(8):1210.CrossRef Hager M, Wenzl R, Riesenhuber S, Marschalek J, Kuessel L, Mayrhofer D, Ristl R, Kurz C, Ott J. The prevalence of incidental endometriosis in women undergoing laparoscopic ovarian drilling for clomiphene-resistant polycystic ovary syndrome: a retrospective cohort study and meta-analysis. J Clin Med. 2019;8(8):1210.CrossRef
19.
go back to reference Rawson JM. Prevalence of endometriosis in asymptomatic women. J Reprod Med. 1991;36(7):513–5.PubMed Rawson JM. Prevalence of endometriosis in asymptomatic women. J Reprod Med. 1991;36(7):513–5.PubMed
20.
go back to reference Yong L, Weiyuan Z. Association between body mass index and endometriosis risk: a meta-analysis. Oncotarget. 2017;8(29):46928.CrossRef Yong L, Weiyuan Z. Association between body mass index and endometriosis risk: a meta-analysis. Oncotarget. 2017;8(29):46928.CrossRef
21.
go back to reference Ferrero S, Anserini P, Remorgida V, Ragni N. Body mass index in endometriosis. Eur J Obstet Gynecol Reprod Biol. 2005;121(1):94–8.CrossRef Ferrero S, Anserini P, Remorgida V, Ragni N. Body mass index in endometriosis. Eur J Obstet Gynecol Reprod Biol. 2005;121(1):94–8.CrossRef
22.
go back to reference Matalliotakis IM, Cakmak H, Fragouli YG, Goumenou AG, Mahutte NG, Arici A. Epidemiological characteristics in women with and without endometriosis in the Yale series. Arch Gynecol Obstet. 2008;277(5):389–93.CrossRef Matalliotakis IM, Cakmak H, Fragouli YG, Goumenou AG, Mahutte NG, Arici A. Epidemiological characteristics in women with and without endometriosis in the Yale series. Arch Gynecol Obstet. 2008;277(5):389–93.CrossRef
23.
go back to reference Hemmings R, Rivard M, Olive DL, Poliquin-Fleury J, Gagné D, Hugo P, Gosselin D. Evaluation of risk factors associated with endometriosis. Fertil Steril. 2004;81(6):1513–21.CrossRef Hemmings R, Rivard M, Olive DL, Poliquin-Fleury J, Gagné D, Hugo P, Gosselin D. Evaluation of risk factors associated with endometriosis. Fertil Steril. 2004;81(6):1513–21.CrossRef
24.
go back to reference Kempers RD, Dockerty MB, Hunt AB, Symmonds RE. Significant postmenopausal endometriosis. Surg Gynecol Obstet. 1960;111:348–56.PubMed Kempers RD, Dockerty MB, Hunt AB, Symmonds RE. Significant postmenopausal endometriosis. Surg Gynecol Obstet. 1960;111:348–56.PubMed
25.
go back to reference Koninckx PR, Anastasia U, Adamyan L, Tahlak M, Keckstein J, Martin DC. The epidemiology of endometriosis is poorly known since the pathophysiology and the diagnosis are unclear. Best Pract Res Clin Obstet Gynaecol. 2020;71:14–26.CrossRef Koninckx PR, Anastasia U, Adamyan L, Tahlak M, Keckstein J, Martin DC. The epidemiology of endometriosis is poorly known since the pathophysiology and the diagnosis are unclear. Best Pract Res Clin Obstet Gynaecol. 2020;71:14–26.CrossRef
26.
go back to reference Cramer DW, Missmer SA. The epidemiology of endometriosis. Ann N Y Acad Sci. 2002;955(1):11–22.CrossRef Cramer DW, Missmer SA. The epidemiology of endometriosis. Ann N Y Acad Sci. 2002;955(1):11–22.CrossRef
27.
go back to reference Abbas S, Ihle P, Köster I, Schubert I. Prevalence and incidence of diagnosed endometriosis and risk of endometriosis in patients with endometriosis-related symptoms: findings from a statutory health insurance-based cohort in Germany. Eur J Obstet Gynecol Reprod Biol. 2012;160(1):79–83.CrossRef Abbas S, Ihle P, Köster I, Schubert I. Prevalence and incidence of diagnosed endometriosis and risk of endometriosis in patients with endometriosis-related symptoms: findings from a statutory health insurance-based cohort in Germany. Eur J Obstet Gynecol Reprod Biol. 2012;160(1):79–83.CrossRef
28.
go back to reference Mahmood TA, Templeton A. Prevalence and genesis of endometriosis. Hum Reprod. 1991;6(4):544–9.CrossRef Mahmood TA, Templeton A. Prevalence and genesis of endometriosis. Hum Reprod. 1991;6(4):544–9.CrossRef
29.
go back to reference De Ziegler D, Borghese B, Chapron C. Endometriosis and infertility: pathophysiology and management. Lancet. 2010;376(9742):730–8.CrossRef De Ziegler D, Borghese B, Chapron C. Endometriosis and infertility: pathophysiology and management. Lancet. 2010;376(9742):730–8.CrossRef
30.
go back to reference Hunter RH. Tubal ectopic pregnancy: a patho-physiological explanation involving endometriosis. Hum Reprod. 2002;17(7):1688–91.CrossRef Hunter RH. Tubal ectopic pregnancy: a patho-physiological explanation involving endometriosis. Hum Reprod. 2002;17(7):1688–91.CrossRef
31.
go back to reference Farland LV, Prescott J, Sasamoto N, Tobias DK, Gaskins AJ, Stuart JJ, Carusi DA, Chavarro JE, Horne AW, Rich-Edwards JW, Missmer SA. Endometriosis and risk of adverse pregnancy outcomes. Obstet Gynecol. 2019;134(3):527–36.CrossRef Farland LV, Prescott J, Sasamoto N, Tobias DK, Gaskins AJ, Stuart JJ, Carusi DA, Chavarro JE, Horne AW, Rich-Edwards JW, Missmer SA. Endometriosis and risk of adverse pregnancy outcomes. Obstet Gynecol. 2019;134(3):527–36.CrossRef
Metadata
Title
Prevalence of endometriosis in women undergoing laparoscopic surgery for various gynaecological indications at a Jordanian referral centre: gaining insight into the epidemiology of an important women's health problem
Authors
Nadia Muhaidat
Shawqi Saleh
Kamil Fram
Mohammed Nabhan
Nadia Almahallawi
Saif Aldeen Alryalat
Mutasem Elfalah
Mohammed Elfalah
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2021
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-021-01530-y

Other articles of this Issue 1/2021

BMC Women's Health 1/2021 Go to the issue