Progression of endometriosis in non-medically managed adolescents: a case series.
BACKGROUND
Endometriosis is considered a progressive disease that can cause chronic pelvic pain and infertility. A combined medical-surgical approach is the best method to slow the progression of endometriosis. Adolescents who are not maintained on a medical regimen postoperatively may be at risk for disease progression.


METHODS
This is a case series of three adolescent patients who presented at 13 to 16 years of age with complaint of severe pelvic pain and were diagnosed with stage 1 endometriosis at the time of laparoscopy. They were then prescribed menstrual suppressive therapy but did not remain compliant with their regimens.


CONCLUSIONS
Each patient returned to the operating room and underwent a second laparoscopy which revealed that each patient's disease had progressed to a higher stage. Without combined surgical-medical management, disease worsens, and places patients at risk for severe chronic pelvic pain as well as infertility.
Children's Hospital Boston, Division of Gynecology, Boston, Massachusetts, USA.
Cecile A
CA
Unger
Marc R
MR
Laufer
D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003278:Contraceptives, Oral, Hormonal / Q000627:therapeutic use; D018450:Disease Progression; D004715:Endometriosis / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D010535:Laparoscopy; D010349:Patient Compliance; D017699:Pelvic Pain / Q000188:drug therapy / Q000209:etiology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D003278:Contraceptives, Oral, Hormonal