title: Clinical symptoms and diagnostic tools that are related to infertility and hydrosalpinx formation in women with advanced stage endometriosis complicated by endometrioma.
abstract: OBJECTIVE
  The study included patients suffering from stage III-IV endometriosis complicated by an endometrioma (OMA). We investigated the association between age, presence of dysmenorrhea/dyspareunia, preoperative CA 125 level, size of OMA on ultrasonographic exam and infertility as well as the risk of intraoperative detection of hydrosalpinx that was not suspected on pre-operative assessment.
  
  
  METHODS
  The study included patients with stage III-IV endometriosis complicated by OMA who underwent a laparoscopic or open surgery due to pre-diagnosis of infertility or adnexal mass.
  
  
  RESULTS
  Dysmenorrhea had statistically significant association with infertility (p=0.031). There was no statistically significant relation between age, dyspareunia, preoperative CA 125 level, size of OMA on ultrasonographic exam and infertility (p=0.203, p=0.561, p=0.561 and p=0.668, respectively). No statistically significant relation was found between age, CA 125 level, dysmenorrhea, dyspareunia and detection of an unilateral/bilateral hydrosalpinx, that was not suspected on pre-operative assessment (p=0.179, p=0.295, p=0.895, p=0.424, respectively). There was an association between OMA size (p=0.023) and detection of unilateral/bilateral hydrosalpinx.
  
  
  CONCLUSIONS
  Patients who desire to have children but suffer from severe dysmenorrhea must be preoperatively informed about the possibility of having stage III-IV endometriosis. Infertile patients who are about to undergo an operation, especially due to a large OMA, may turn out to have hydrosalpinx. These patients should be informed preoperatively about the possibility of having salpingectomy or the proximal tubal surgery for improving fertility.
authors.affiliation: Department of Obstetrics and Gynecology, Düzce University Faculty of Medicine, Düzce, Turkey. draliyavuzcan@yahoo.com
authors.forename: Ali
authors.initials: A
authors.lastname: Yavuzcan
authors.forename: Mete
authors.initials: M
authors.lastname: Caglar
authors.forename: Serdar
authors.initials: S
authors.lastname: Dilbaz
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Ustün
authors.forename: Ismail
authors.initials: I
authors.lastname: Ozdemir
authors.forename: Elif
authors.initials: E
authors.lastname: Yildiz
authors.forename: Sitki
authors.initials: S
authors.lastname: Ozbilgeç
authors.forename: Selahattin
authors.initials: S
authors.lastname: Kumru
mesh_terms: D000293:Adolescent; D000328:Adult; D004412:Dysmenorrhea / Q000209:etiology / Q000517:prevention & control; D004715:Endometriosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000209:etiology / Q000517:prevention & control*; D010535:Laparoscopy; D008875:Middle Aged; D010048:Ovarian Cysts / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D058994:Salpingectomy; D012488:Salpingitis / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D014421:Turkey; D055815:Young Adult