The Role of Chronic Endometritis in Endometriosis: A Personalized Diagnostic Tool?

TL;DR

This study explores the connection between chronic endometritis and endometriosis, suggesting it may influence disease progression and treatment response.

Contribution

The study identifies a potential link between chronic endometritis and adenomyosis in endometriosis patients.

Findings

All patients with chronic endometritis had adenomyosis (p = 0.004).

Patients with endometriosis and chronic endometritis reported higher pain during ovulation.

A high prevalence of chronic endometritis was observed in endometriosis patients.

Abstract

(1) Background: Endometriosis and chronic endometritis (CE) are pathologies that are positively correlated and have similar paracrine and immunological alterations. This leads us to wonder whether their interrelationship plays a role in the etiopathogenesis or progression of endometriosis. The purpose of this study is to evaluate whether patients with endometriosis and CE have a more advanced stage of the disease, higher rates of pain, a poorer response to treatment, and a greater association with other pathologies compared to women with endometriosis without CE. (2) Methods: This is a cross-sectional pilot design study of 37 women with endometriosis who underwent endometrial aspiration for the diagnosis of CE and were followed up at the Puerta de Hierro Hospital. (3) Results: All patients with CE in this study had adenomyosis (p = 0.004). There was a relatively homogeneous distribution of CE in the different endometriosis phenotypes. The group of patients with endometriosis and CE indicated higher rates of pain during ovulation and less pain during defecation and sexual intercourse. (4) Conclusions: A high prevalence of CE was observed in patients with endometriosis, as well as a trend suggesting a relationship between CE and adenomyosis that should be studied. The following article attempts to reflect a link found between endometriosis and chronic endometritis, which would be important when prescribing personalized medicine, as it forces us to look for a specific disease in a specific patient profile.

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