ENDOSALPINGIOSIS AND CHRONIC PELVIC PAIN

OBJECTIVE: To show that endosalpingiosis (ES) is a frequently underdia gnosed or misdiagnosed entity in women thought to have endometriosis ( EM) on initial pathologic review and that ES alone may be an independe nt cause of pelvic pain.STUDY DESIGN: A retrospective review of pathol ogy records from gynecologic cases from June 1992 to November 1994 rev ealed 37 cases of EM and 5 cases of ES. These cases were reviewed by a single pathologist (J.M.), who assigned a final diagnosis. Preoperati ve diagnosis or symptoms that led to surgery were compared to the init ial and final pathologic diagnoses. RESULTS: Of the 37 cases with the initial diagnosis of EM, 64.9% had EM only (group I), 18.9% had both E M and ES (group II), and 16.2% had ES alone (group III). Of the five p atients with an initial diagnosis of ES, 80% had ES (group IV), while 20% had both ES and EM (group V). In patients who had ES as their fina l diagnosis (groups III and IV), 70% had chronic pelvic pain or presum ed endometriosis as a preoperative diagnosis. This tons similar to the 53.1% of patients with it final diagnosis of EM who had the same preo perative diagnosis. CONCLUSION: We conclude that ES is more common tha n once thought. Furthermore, when an initial diagnosis of EM is made, further review may reveal that many of these cases are a combination o f both EM and ES, while still others may be ES alone. ES, which has be en long been thought to be clinically insignificant, could be a source of pelvic pain.