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Is tubal endometriosis an asymmetric disease? A 17-year retrospective study

  • General Gynecology
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Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To investigate whether there are left–right asymmetries in tubal endometriosis and the factors affecting this predisposition.

Methods

Women who underwent salpingectomy for gynecological diseases and were diagnosed with tubal endometriosis between January 2002 and July 2019 were included in the study. The frequencies of left and right tubal endometriosis were compared with the expected 50% using a binominal test. The demographic characteristics and presence of ovarian endometrioid cysts, adenomyosis, and hydrosalpinx were also analyzed.

Results

During the study period of more than 17 years, 305 women were diagnosed with tubal endometriosis. The distribution of tubal endometriosis in the left or right fallopian tubes was analyzed. Tubal endometriosis was found in the left fallopian tube in 168 (55.08%) women, in the right fallopian tube in 93 (30.49%), and bilaterally in 44 (14.43%). Left unilateral tubal endometriosis was found most frequently (64.37%, 168/261), and its incidence was significantly higher than 50% (P < 0.001, binominal test). Furthermore, the frequency of left ovarian endometrioid cysts (58.82%) was higher than that of right ovarian endometrioid cysts (41.18%) (P < 0.001, binominal test).

Conclusion

Our study confirms that tubal endometriosis is a left-side asymmetric disease, and this predisposition is highly consistent with ovarian endometrioid cysts, which supports the transplantation theory of the origin of endometriosis.

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Abbreviations

BD:

Benign disease

EM:

Endometriosis

MT:

Malignant tumor

No-TEM:

Fallopian tubes without endometriosis

OEC:

Ovarian endometrioid cysts

TEM or tubal EM:

Tubal endometriosis

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Acknowledgements

We thank staff members of the information department for providing clinical data of the study.

Funding

This study was supported by grants from the National Key Research and Development Program of China [2017YFC1001300], and Shanghai Shenkang Hospital Development Center Clinical Science and Technology Innovation Project [SHDC12018622].

Author information

Author notes

  1. Rui-Hong Xue and Juan Li should be considered similar in author order.

Authors and Affiliations

  1. Department of Gynecology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

    Rui-Hong Xue, Zhen Huang, Zheng-Zheng Li & Qin Lin

  2. Department of Pathology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

    Juan Li

  3. Center of Reproductive Medicine, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, No. 910 Hengshan Road, Shanghai, 200030, China

    He-Feng Huang

  4. Department of Information, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China

    Lei Chen

  5. Institute of Embryo-Fetal Original Adult Disease Affiliated To Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, Shanghai, China

    He-Feng Huang

  6. Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China

    He-Feng Huang

  7. Shanghai Municipal Key Clinical Specialty, Shanghai, China

    He-Feng Huang

Authors
  1. Rui-Hong Xue
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  2. Juan Li
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  7. He-Feng Huang
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Contributions

HFH conceived the study, participated in its design, supervised the study, and critically revised the manuscript. RHX and JL were responsible for writing the manuscript and the statistical analysis. ZH and ZZL participated in the writing and revision of the manuscript. QL critically revised the manuscript. LC contributed to exporting and checking data from the hospital digital system. All the authors substantially contributed to the revision of the manuscript. All authors critically reviewed the report and approved the final manuscript.

Corresponding author

Correspondence to He-Feng Huang.

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Conflict of interest

The authors report no conflicts of interest.

Ethical approval

The retrospective study was approved by the ethics committee on human research at International Peace Maternity and Child Health Hospital, Shanghai, China. Review Board: (GKLW) 2017-81 on December 29, 2017.

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Xue, RH., Li, J., Huang, Z. et al. Is tubal endometriosis an asymmetric disease? A 17-year retrospective study. Arch Gynecol Obstet 301, 721–727 (2020). https://doi.org/10.1007/s00404-020-05465-x

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  • DOI: https://doi.org/10.1007/s00404-020-05465-x

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