Endometriosis
rates elevated in septate uterus
Women with a specific type of uterine anomaly appear
to be at high risk of endometriosis, even though their
menstrual flow is not obstructed, researchers report.
It is known that obstructive Müllerian anomalies
are linked to a high incidence of endometriosis, an
association consistent with the idea that endometriosis
results from retrograde menstruation. However, researchers
have now shown that endometriosis rates are also increased
in women with a septate uterus, as a non-obstructive
anomaly.
Comparing 120 patients with a septate uterus and 486
infertility patients with normal hysteroscopy and laparoscopy
findings, Nawroth et al found a higher incidence of
endometriosis in the former group (25.8 percent vs 15.2
percent).
If this coincidence is confirmed by others, the initial
finding of a septate uterus in infertility patients
should prompt a combined hysteroscopy and laparoscopy
to be conducted to evaluate the presence and extension
of endometriosis and dissect the septum, according to
Nawroth and colleagues: "This strategy would lead
to an increased chance of pregnancy in infertile patients
by ablative therapy of even minimal or mild endometriosis
and to a lower abortion rate by the dissection of the
septum".
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