Vaginal parturition decreases recurrence of endometriosis.
OBJECTIVE
To evaluate the role of parturition in the recurrence of endometriosis.


METHODS
Retrospectively analyzed, prospectively obtained data.


METHODS
Unit of Physiopathology of Reproduction, Health Care Unit of Rimini, and University of Bologna Cervesi General Hospital, Cattolica, Italy.


METHODS
Three hundred forty-five patients with stage II-IV endometriosis, dysmenorrhea, and infertility were treated for endometriosis and divided into four groups according to parity and mode of parturition.


METHODS
The patients were laparoscopically treated for endometriosis upon the occurrence and recurrence of the disease. Ultrasound measurements of the uterine internal ostium (IOS) were performed at each study interval.


METHODS
Degree of dysmenorrhea, occurrence and recurrence of endometriosis, and uterine IOS measurements were established and related to parity and mode of parturition.


RESULTS
After parturition, dysmenorrhea recurrence was significantly higher in nulliparous women than in women with vaginal parturition. The endometriosis recurrence rate was higher in women who did not have vaginal parturition. The IOS significantly enlarged after vaginal delivery but not after cesarean delivery. There were significant negative correlations between IOS and the recurrence of endometriosis and dysmenorrhea. Odds ratios indicated that as the IOS enlarged, the risk of recurrence decreased.


CONCLUSIONS
Vaginal parturition plays a protective role in the recurrence of endometriosis.
Bulletti
Carlo
C
Unit of Physiopathology of Reproduction, Cattolica General Hospital and University of Bologna, Bologna, Italy. bulleticarlo@libero.it
Montini
Anna
A
Setti
Paolo Levi
PL
Palagiano
Antonio
A
Ubaldi
Filippo
F
Borini
Andrea
A
D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D004412:Dysmenorrhea / Q000473:pathology; D004715:Endometriosis / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009929:Organ Size; D036801:Parturition / Q000502:physiology*; D011247:Pregnancy; D012189:Retrospective Studies; D055502:Secondary Prevention; D014591:Uterine Diseases / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control*; D014599:Uterus / Q000033:anatomy & histology / Q000473:pathology; D014621:Vagina / Q000033:anatomy & histology / Q000473:pathology; D055815:Young Adult