Arguments for a left lateral predisposition of endometrioma.
OBJECTIVE
To analyze a hypothesis regarding the pathogenesis of endometriosis.


METHODS
Retrospective study.


METHODS
Two academic endometriosis referral centers.


METHODS
We evaluated operative and pathologic reports of 251 women who underwent laparoscopic or laparotomy treatment of endometrioma from August 1996 to February of 2002 at Yale University School of Medicine and at the University of Crete Department of Obstetrics and Gynecology.


METHODS
Laparascopic examination.


METHODS
Statistical methods included chi(2) and Mann-Whitney U tests measuring incidence of right- vs. left-sided endometria.


RESULTS
One hundred seventy patients from Yale University and 81 Greek patients participated in this study. Endometrioma was significantly more frequent in the left ovary (139 of 206 [67.4%]) than in the right ovary (67 of 206 [32.6%]; odds ratio [OR] = 4.3; 95% confidence interval [CI) 2.9-6.5; chi(2) = 48.9) and significantly different from the expected proportion of 50% (chi(2) = 25.2). When bilateral endometriomas were included, 62.1% (184 of 296) were left-sided and 37.15 (112 of 296) were right-sided (OR = 17.5; 95% CI 1.9-3.8; chi(2) = 34.1). Dilated ovarian veins in were found in 22 (68.7%) of 32 Greek cases with endometrioma. All 20 women with left endometrioma had left ovarian vein dilated.


CONCLUSIONS
We suggest a new mechanical theory of implication, the female varicocele theory, which could play an important role in the development of ovarian endometriosis or endometriomas.
Matalliotakis
Ioannis M
IM
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Yale University School of Medicine, New Haven, Connecticut, USA. matakgr@yahoo.com
Cakmak
Hakan
H
Koumantakis
Emmanuel E
EE
Margariti
Anastasia
A
Neonaki
Maria
M
Goumenou
Anastasia G
AG
D000328:Adult; D015331:Cohort Studies; D004198:Disease Susceptibility / Q000209:etiology / Q000473:pathology*; D004715:Endometriosis / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D010049:Ovarian Diseases / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D010053:Ovary / Q000098:blood supply / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D014648:Varicose Veins / Q000150:complications