SERIAL LAPAROSCOPIES OVER 30 MONTHS SHOW THAT ENDOMETRIOSIS IN CAPTIVE BABOONS (PAPIO-ANUBIS, PAPIO-CYNOCEPHALUS) IS A PROGRESSIVE DISEASE

Objective: To test the hypothesis that spontaneous endometriosis is a progressive disease in baboons. Design and Setting: Prospective cohort study, Institute of Primate Research, Nairobi, Kenya. Participants: T welve baboons with histologically proven spontaneous endometriosis. In terventions: Fifty-four serial laparoscopies (4.2 +/- 1.9 per animal, range 1 to 7) were performed after 1 to 3 months (n = 2), 4 to 6 month s (n = 1), 7 to 9 months (n = 6), 10 to 12 months (n = 17), 13 to 15 m onths (n = 7), 16 to 18 months (n = 1), 19 to 21 months (n = 8), 22 to 24 months (n = 8), 25 to 27 months (n = 2), and 30 to 32 months (n = 2). Main Outcome Measure: During each laparoscopy the pelvis was exami ned for the presence of endometriosis. The number, size, and type of e ndometriotic implants were noted on a pelvic map and both endometriosi s score and stage were calculated. Remodeling was defined as a change in laparoscopic appearance (typical, subtle, suspicious) of an individ ual endometriotic lesion. Data were analyzed by a signed rank test. Re sults: Endometriosis was progressive as shown by the significant incre ase in the number and surface of lesions and in endometriosis scores a fter 24 months. The total number of endometriotic lesions after 24 mon ths consisted of 69% new (and mostly subtle) implants, 10% remodeled l esions, and 21% unchanged implants. Conclusions: This study demonstrat ed that endometriosis in captive baboons undergoing repeated laparosco pies is a dynamic and moderately progressive disease with periods of d evelopment and regression and active remodeling between different type s of lesions.