Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Women's Health
Published in: BMC Women's Health 1/2018

Open Access 01-12-2018 | Research article

Factors associated with deep infiltrating endometriosis versus ovarian endometrioma in China: a subgroup analysis from the FEELING study

Authors: Yi Dai, Yingfang Zhou, Xinmei Zhang, Min Xue, Pengran Sun, Jinhua Leng, Charles Chapron

Published in: BMC Women's Health | Issue 1/2018

Login to get access

Abstract

Background

To compare potential factors associated with deep infiltrating endometriosis (DIE) versus ovarian endometrioma (OMA) among endometriosis patients in China.

Methods

A subgroup analysis of factors associated with DIE versus OMA was performed in Chinese women from the FEELING study. This study included 156 OMA patients and 78 DIE patients. Retrospective information on symptoms and previous medical history was collected via face-to-face interviews; patients also completed a questionnaire to provide information on current habits. Univariate and multivariate logistic regression analyses were conducted to identify potential factors that are associated with DIE versus OMA.

Results

From univariate analysis, women who were married, at older age, had any siblings, prior pregnancy, or longer time since age at menarche on the day of visit were more likely to be diagnosed with DIE (P < 0.05). Also, the incidence of previous uterine surgery, menstrual and ovulatory disorders, deep dyspareunia, and gastrointestinal symptoms during menstruation were major factors that were significantly associated with the diagnosis of DIE (P < 0.05). Multivariate analysis showed that women with any siblings, gastrointestinal symptoms during menstruation, or eating a greater number of fruit/vegetables per day were more likely to be diagnosed with DIE. Meanwhile, eating organic food and experiencing stress were major factors that are associated with the diagnosis of OMA.

Conclusions

The findings provide additional information on the potential risk factors that are associated with DIE, compared with OMA among Chinese endometriosis patients. The results may help to better understand DIE versus OMA, and aid in earlier risk stratification and diagnosis of the patients.

Trial registration

NCT01351051. Registered 10 May 2011.
Literature
1.
Fourquet J, Baez L, Figueroa M, Iriarte RI, Flores I. Quantification of the impact of endometriosis symptoms on health-related quality of life and work productivity. Fertil Steril. 2011;96(1):107–12.CrossRef
2.
3.
Bozdag G. Recurrence of endometriosis: risk factors, mechanisms and biomarkers. Women's health (London, England). 2015;11(5):693–9.CrossRef
4.
Brawn J, Morotti M, Zondervan KT, Becker CM, Vincent K. Central changes associated with chronic pelvic pain and endometriosis. Hum Reprod Update. 2014;20(5):737–47.CrossRef
5.
de Ziegler D, Borghese B, Chapron C. Endometriosis and infertility: pathophysiology and management. Lancet (London, England). 2010;376(9742):730–8.CrossRef
6.
Fritzer N, Tammaa A, Salzer H, Hudelist G. Dyspareunia and quality of sex life after surgical excision of endometriosis: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2014;173:1–6.CrossRef
7.
Porpora MG, Pallante D, Ferro A, Crisafi B, Bellati F, Benedetti Panici P. Pain and ovarian endometrioma recurrence after laparoscopic treatment of endometriosis: a long-term prospective study. Fertil Steril. 2010;93(3):716–21.CrossRef
8.
Chapron C, Lang JH, Leng JH, Zhou Y, Zhang X, Xue M, Popov A, Romanov V, Maisonobe P, Cabri P. Factors and regional differences associated with endometriosis: a multi-country, case-control study. Adv Ther. 2016;33(8):1385–407.CrossRef
9.
Eskenazi B, Warner ML. EPIDEMIOLOGY OF ENDOMETRIOSIS. BMJ. 1993;306(6882):930–1.
10.
Meuleman C, Vandenabeele B, Fieuws S, Spiessens C, Timmerman D, D'Hooghe T. High prevalence of endometriosis in infertile women with normal ovulation and normospermic partners. Fertility & Sterility. 2009;92(1):68–74.CrossRef
11.
Nezhat C. Rectal surgery for endometriosis--should we be aggressive? J Am Assoc Gynecol Laparosc. 2003;10(4):578 author reply 578-579.CrossRef
12.
Koninckx PR, Timmermans B, Meuleman C, Penninckx F. Complications of CO2-laser endoscopic excision of deep endometriosis. J Am Assoc Gynecol Laparosc. 1996;11(10):2263–8.
13.
Lukic A, Di Properzio M, De Carlo S, Nobili F, Schimberni M, Bianchi P, Prestigiacomo C, Moscarini M, Caserta D. Quality of sex life in endometriosis patients with deep dyspareunia before and after laparoscopic treatment. Arch Gynecol Obstet. 2016;293(3):583–90.CrossRef
14.
Friedl F, Riedl D, Fessler S, Wildt L, Walter M, Richter R, Schussler G, Bottcher B. Impact of endometriosis on quality of life, anxiety, and depression: an Austrian perspective. Arch Gynecol Obstet. 2015;292(6):1393–9.CrossRef
15.
Parazzini F, Chiaffarino F, Surace M, Chatenoud L, Cipriani S, Chiantera V, Benzi G, Fedele L. Selected food intake and risk of endometriosis. Human reproduction (Oxford, England). 2004;19(8):1755–9.CrossRef
16.
Missmer SA, Hankinson SE, Spiegelman D, Barbieri RL, Michels KB, Hunter DJ. In utero exposures and the incidence of endometriosis. Fertil Steril. 2004;82(6):1501–8.CrossRef
17.
Matalliotakis IM, Arici A, Cakmak H, Goumenou AG, Koumantakis G, Mahutte NG. Familial aggregation of endometriosis in the Yale series. Arch Gynecol Obstet. 2008;278(6):507–11.CrossRef
18.
Missmer SA, Hankinson SE, Spiegelman D, Barbieri RL, Marshall LM, Hunter DJ. Incidence of laparoscopically confirmed endometriosis by demographic, anthropometric, and lifestyle factors. Am J Epidemiol. 2004;160(8):784–96.CrossRef
19.
Zhou Y, Wu B. Epidemiological study on risk factors of pelvic endometriosis. Zhonghua fu chan ke za zhi. 1995;30(6):356–9.PubMed
20.
Nisolle M, Donnez J. Peritoneal endometriosis, ovarian endometriosis, and adenomyotic nodules of the rectovaginal septum are three different entities. Fertil Steril. 1997;68(4):585–96.CrossRef
21.
Holt VL, Weiss NS. Recommendations for the design of epidemiologic studies of endometriosis. Epidemiology. 2000;11(6):654–9.CrossRef
22.
Redwine DB. Age-related evolution in color appearance of endometriosis. Fertil Steril. 1987;48(6):1062–3.CrossRef
23.
Harirchian P, Gashaw I, Lipskind ST, Braundmeier AG, Hastings JM, Olson MR, Fazleabas AT. Lesion kinetics in a non-human primate model of endometriosis. Hum Reprod. 2012;27(8):2341–51.CrossRef
24.
Gylfason JT, Kristjansson KA, Sverrisdottir G, Jonsdottir K, Rafnsson V, Geirsson RT. Pelvic endometriosis diagnosed in an entire nation over 20 years. Am J Epidemiol. 2010;172(3):237–43.CrossRef
25.
Busacca M, Vignali M. Ovarian endometriosis: from pathogenesis to surgical treatment. Curr Opin Obstet Gynecol. 2003;15(4):321.PubMed
26.
Montanari G, Di Donato N, Benfenati A, Giovanardi G, Zannoni L, Vicenzi C, Solfrini S, Mignemi G, Villa G, Mabrouk M, et al. Women with deep infiltrating endometriosis: sexual satisfaction, desire, orgasm, and pelvic problem interference with sex. J Sex Med. 2013;10(6):1559–66.CrossRef
27.
Koninckx PR, Ussia A, Adamyan L, Wattiez A, Donnez J. Deep endometriosis: definition, diagnosis, and treatment. Fertil Steril. 2012;98(3):564.CrossRef
28.
Claudia T, Serena P, Pietro S, Charles C, Felice P. Pathogenetic mechanisms of deep infiltrating endometriosis. Reprod Sci. 2015;22(9):1053–9.CrossRef
29.
gynecologists ACoO. ACOG Committee Opinion. Number 310, April 2005. Endometriosis in adolescents. Obstet Gynecol 2005;105(4):921.
30.
Makhaldiani N. Peritoneal endometriosis, ovarian endometriosis, and adenomyotic nodules of the rectovaginal septum are three different entities. Fertil Steril. 1997;68(4):585–96.CrossRef
31.
Chapron C, Souza C, Borghese B, Lafaypillet MC, Santulli P, Bijaoui G, Goffinet F, Ziegler DD. Oral contraceptives and endometriosis: the past use of oral contraceptives for treating severe primary dysmenorrhea is associated with endometriosis, especially deep infiltrating endometriosis. Hum Reprod. 2011;26(8):2028.CrossRef
32.
Chapron C, Lafaypillet MC, Monceau E, Borghese B, Ngô C, Souza C, De ZD. Questioning patients about their adolescent history can identify markers associated with deep infiltrating endometriosis. Fertil Steril. 2011;95(3):877–81.CrossRef
33.
Lafay Pillet MC, Huchon C, Santulli P, Borghese B, Chapron C, Fauconnier A. A clinical score can predict associated deep infiltrating endometriosis before surgery for an endometrioma. Hum Reprod. 2014;29(8):1666–76.CrossRef
34.
Cornillie FJ, Oosterlynck D, Lauweryns JM, Koninckx PR. Deeply infiltrating pelvic endometriosis: histology and clinical significance. Fertil Steril. 1990;53(6):978–83.CrossRef
35.
Calhazjorge C, Mol BW, Nunes J, Costa AP. Clinical predictive factors for endometriosis in a Portuguese infertile population. Hum Reprod. 2004;19(9):2126–31.CrossRef
36.
Ding T, Yan LI, Wang WW. Analysis on the risk factors of endometriosis among the patients undergoing gynecological operation. In: Maternal & Child Health Care of China; 2012.
37.
Hansen SO, Knudsen UB. Endometriosis, dysmenorrhoea and diet. European Journal of Obstetrics Gynecology & Reproductive Biology. 2013;169(2):162–71.CrossRef
38.
Halpern G, Schor E, Kopelman A. Nutritional aspects related to endometriosis. Rev Assoc Med Bras. 2015;61(6):519–23.CrossRef
39.
Parazzini F, Chiaffarino F, Surace M, Chatenoud L, Cipriani S, Chiantera V, Benzi G, Fedele L. Selected food intake and risk of endometriosis. Hum Reprod. 2005;20(1):312.CrossRef
40.
Trabert B, Peters U, De Roos AJ, Scholes D, Holt VL. Diet and risk of endometriosis in a population-based case-control study. Br J Nutr. 2011;105(3):459–67.CrossRef
41.
Evans JM. An integrative approach to fibroids, endometriosis, and breast Cancer prevention. Integrative Medicine. 2008;7(5):28–31.
42.
Seear K, Clarke CL. 'Nobody really knows what it is or how to treat it': why women with endometriosis do not comply with healthcare advice. Health Risk Soc. 2009;11(4):367–85.CrossRef
43.
Quiñones M, Urrutia R, Torresreverón A, Vincent K, Flores I. Anxiety, coping skills and hypothalamus-pituitary-adrenal (HPA) axis in patients with endometriosis. Journal of Reproductive Biology & Health. 2015;3(1):2.CrossRef
44.
Lazzeri L, Vannuccini S, Orlandini C, Luisi S, Zupi E, Nappi RE, Petraglia F. Surgical treatment affects perceived stress differently in women with endometriosis: correlation with severity of pain. Fertil Steril. 2015;103(2):433–8.CrossRef
45.
Borghese B, Chartier M, Souza C, Santulli P, Lafaypillet MC, Ziegler DD, Chapron C. ABO and rhesus blood groups and risk of endometriosis in a French Caucasian population of 633 patients living in the same geographic area. Biomed Res Int. 2014;2014:618964.CrossRef
46.
Chapron C, Souza C, De ZD, Lafaypillet MC, Ngô C, Bijaoui G, Goffinet F, Borghese B. Smoking habits of 411 women with histologically proven endometriosis and 567 unaffected women. Fertil Steril. 2010;94(6):2353.CrossRef
47.
Kamergorodsky G, Ribeiro PA, Galvão MA, Abrão MS, Donadio N, Lemos NL, Aoki T. Histologic classification of specimens from women affected by superficial endometriosis, deeply infiltrating endometriosis, and ovarian endometriomas. Fertil Steril. 2009;92(6):2074.CrossRef
48.
Parazzini F, Cipriani S, Bianchi S, Gotsch F, Zanconato G, Fedele L. Risk factors for deep endometriosis: a comparison with pelvic and ovarian endometriosis. Fertil Steril. 2008;90(1):174–9.CrossRef
49.
Lafay Pillet MC, Schneider A, Borghese B, Santulli P, Souza C, Streuli I, de Ziegler D, Chapron C. Deep infiltrating endometriosis is associated with markedly lower body mass index: a 476 case-control study. Human reproduction (Oxford, England). 2012;27(1):265–72.CrossRef
50.
Bruno B. Low birth weight is strongly associated with the risk of deep infiltrating endometriosis: results of a 743 case-control study. PLoS One. 2015;10(2).
51.
Chapron C, Pietin VCB. Associated ovarian endometrioma is a marker for greater severity of deeply infiltrating endometriosis. Fertil Steril. 2009;92(2):453–7.CrossRef
52.
Setälä M, Härkki P, Suvitie P, Fraser J, Jalkanen J, Kössi J, Perheentupa A, Mäkinen J. Is the presence of endometrioma always associated with more severe disease? Gynecol Surg. 2011;8(3):299–304.CrossRef
Metadata
Title
Factors associated with deep infiltrating endometriosis versus ovarian endometrioma in China: a subgroup analysis from the FEELING study
Authors
Yi Dai
Yingfang Zhou
Xinmei Zhang
Min Xue
Pengran Sun
Jinhua Leng
Charles Chapron
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2018
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-018-0697-7

Other articles of this Issue 1/2018

BMC Women's Health 1/2018 Go to the issue

Research article

Evaluation of human-papillomavirus testing and visual inspection for cervical cancer screening in Rwanda

Research article

Facing HIV infection and unintended pregnancy: Rakai, Uganda, 2001–2013

Research article

“It has not occurred to me to see a doctor for that kind of feeling”: a qualitative study of Filipina immigrants’ perceptions of help seeking for mental health problems

Case report

Efficient treatment of chronic endometritis through a novel approach of intrauterine antibiotic infusion: a case series

Research article

Knowledge of HPV and acceptability of HPV vaccine among women in western China: a cross-sectional survey

Research article

Patterns of missing data in the use of the endometriosis symptom diary