The incidence of endometriosis in the general population has been reported to range from 4% to 32%. A more realistic figure is probably 7.5%. An incidence of 7.4% was found in 42 of 566 multiparous women undergoing tubal sterilization at Baylor College of Medicine, Houston. Twelve of the 42 (29%) were less than five months postpartum. Hispanics had an incidence of endometriosis similar to that of whites and blacks. Indigent status had no bearing on the presence of endometriosis. A higher incidence of spontaneous abortion was found in patients with endometriosis, but the difference was not statistically significant.
PIP: Patients undergoing laparoscopic tubal sterilization at Baylor College of Medicine in Houston from 1985-1986 constituted a study group for collecting data on the incidence and demographics of endometriosis in women who present for care not associated with gynecologic symptoms. A lesion was not considered to be an endometriosis implant unless it was highly typical -- brown, black or blue, and circumscribed by fibrosis. Laparoscopy was performed with a single-puncture technique. The entire pelvis, including the cul-de-sac and ovarian fossae, was observed for evidence of pelvic disease, including adhesions and endometriosis. 566 women underwent laparoscopy and pelvic evaluation; endometriosis was identified in 42 women. 28 of the 42 cases were minimal, 10 mild, and 4 moderate. 16 of 42 patients (38%) with endometriosis as compared to 235 of 524 (44.8%) without endometriosis complained of dysmenorrhea. The mean age, gravidity, and parity did not differ in endometriosis patients as compared to the other women. 80.4% of the women were indigent. Neither race nor indigent status differed in endometriosis patients as compared to the other women. 12 of the 42 patients with endometriosis were less than 5 months postpartum; 14 of the 42 patients with endometriosis were current oral contraceptive users (33.3%) as compared to 222 of the 524 (42.4%) without endometriosis. Current OC use appeared to be protective, but statistical significance was lacking. While spontaneous abortions were more common in patients with endometriosis, statistical significance also was lacking. In sum, a 7.4% incidence of endometriosis was found in multiparous fertile women.