Study Sheds Light the Occurrence and Management of Cervical Endometriosis

Most women with post-coital and intermenstrual bleeding had cervical endometriosis.

Key Points

Highlights: 

• Most women who had a hysterectomy to treat abnormal vaginal bleeding had cervical endometriosis.
• Cervical endometriosis was also the most common diagnosis among women who experienced bleeding between periods and after intercourse.

Importance:

• A better understanding of cervical endometriosis can ensure women receive the best possible treatment and avoid unnecessary surgical treatment.

What’s done here:

• Researchers analyzed 10 years ' worth of data and also conducted a systematic literature review.

Key results:

• 44% of women who had bleeding in between periods or after sex, abnormal uterine bleeding, and painful periods or intercourse had an initial cervical biopsy confirming a diagnosis of cervical endometriosis.
• 48% of these women received a diagnosis of cervical endometriosis after a hysterectomy. 
• The main reasons for hysterectomy were abnormal uterine bleeding and fibroids or adenomyosis.
• Treatments were mainly based on presentation at time of diagnosis in the literature review.

Lay Summary

Most women who had a hysterectomy to treat abnormal uterine bleeding had cervical endometriosis, according to a new study published in the International Journal of Gynecology & Obstetrics. Cervical endometriosis was the main diagnosis in women who had bleeding following sex or in between periods, the study also found.

“Investigations should be considered to rule out [cervical endometriosis] to have the potential for conservative alternative treatment rather than major surgery,” the study authors said. “There is no clear guidance on managing [cervical endometriosis] and good-quality studies are required to provide conclusive treatment options”.

To better identify cases of cervival endometriosis and gather information about its management, a team of researchers led by Dr. Neelam Potdar, a consultant gynechologist at the University Hospital of Leicester NHS Trust in Leicester, UK examined 10 years of data to identify cases of cervical endometriosis and conducted a systematic review of the literature of studies published between 1949 and 2022 to collect evidence about the management of the disease.

The results showed that in the case series, 25 women had bleeding between periods and after sex, 24 women had abnormal uterine bleeding, 12 had painful periods or painful intercourse. Of these, a little less than half (44%) had an initial cervical biopsy, which confirmed a diagnosis of cervical endometriosis and 48% were diagnosed with cervical endometriosis following a hysterectomy. The main reasons for hysterectomy were abnormal uterine bleeding in 36% of cases and fibroids or adenomyosis in 28% of cases. 

The researchers identified 1737 studies during the systematic review. They analyzed 181 of them for eligibility, and identified 14 that reported data on individual case reports and case series specifically on the treatment of cervical endometriosis. A total of nine full-text and abstract studies were found to gather information about potential treatment options for the condition. Treatments were mainly based on presentation at time of diagnosis.

Cervical endometriosis is a rare for of endometrisois characterized by the presence of endometriosis on the cervical portion of uterus.

Research Source: https://pubmed.ncbi.nlm.nih.gov/39932035/