Characteristics of uterine contractility during menses in women with mild to moderate endometriosis.
OBJECTIVE
To establish the role of uterine contractions in retrograde menstruation with subsequent abdominal implantation of endometrial tissue.


METHODS
Controlled prospective study.


METHODS
University hospital-based study.


METHODS
Infertile women with (n = 22) and without (n = 22) endometriosis.


METHODS
Frequency, amplitude, and basal pressure tone of uterine contractions; correlation of contractions with retrograde bleeding and presence of viable endometrial cells; and dysmenorrhea before and 3 and 24 months after surgery.


RESULTS
Compared with controls, patients with endometriosis had uterine contractions with higher frequency (22.73 +/- 5.66 osc/10 min vs. 11.09 +/- 3.26 osc/10 min), amplitude (20.83 +/- 3.94 mm Hg vs. 6.77 +/- 2.83 mm Hg), and basal pressure tone (50.14 +/- 16.30 mm Hg vs. 24.68 +/- 6.14 mm Hg). Dysmenorrhea was scored as 4.09 +/- 1.44 in patients with endometriosis and 0.86 +/- 1.42 in controls. Retrograde bleeding was found in 73% of patients with endometriosis vs. 9% of controls, and only 45% of patients with endometriosis had viable endometrial cells in the cul-de-sac.


CONCLUSIONS
Endometriosis may result from abnormal myometrial contractility through tubal transportation, dissemination, and implantation of endometrial viable cells into the abdomen.
Bulletti
Carlo
C
Department of Obstetrics, Gynecology and Physiopathology of Reproduction, Infermi General Hospital, Rimini, Italy. bull@infotel.it
De Ziegler
Dominique
D
Polli
Valeria
V
Del Ferro
Elena
E
Palini
Simone
S
Flamigni
Carlo
C
D000328:Adult; D004412:Dysmenorrhea / Q000453:epidemiology / Q000209:etiology; D004715:Endometriosis / Q000150:complications / Q000473:pathology / Q000503:physiopathology*; D004717:Endometrium / Q000473:pathology; D005260:Female; D006801:Humans; D015994:Incidence; D008598:Menstruation / Q000502:physiology*; D012720:Severity of Illness Index; D014590:Uterine Contraction / Q000502:physiology*; D014592:Uterine Hemorrhage / Q000209:etiology