13662 Abnormal Uterine Bleeding As a Primary Complaint in Patients with Endometriosis: A Missed Diagnostic Opportunity?
Recommended Citation
Jiang M, Kheil M, Su W, Wegienka G, Bossick A, Vilkins AL, Abood J. 13662 Abnormal Uterine Bleeding As a Primary Complaint in Patients with Endometriosis: A Missed Diagnostic Opportunity?. J Minim Invasive Gynecol 2025; 32(11):S77-S78.
Document Type
Conference Proceeding
Publication Date
11-1-2025
Publication Title
J Minim Invasive Gynecol
Abstract
Study Objective: To evaluate whether abnormal uterine bleeding (AUB) is a frequently overlooked initial presentation among patients ultimately diagnosed with endometriosis, and to highlight the need for comprehensive evaluation and symptom screening in this population. Design: Retrospective cohort study. Setting: Academic-affiliated health system. Patients or Participants: Electronic medical records were reviewed for all patients who underwent minimally invasive surgical excision with pathology-confirmed endometriosis between September 2019 and January 2025. Preoperative symptoms and pathology findings were retrieved from clinic documentation and pathology reports. Interventions: None. Measurements and Primary Results: This study included 165 patients who underwent minimally invasive surgical excision with pathology-confirmed endometriosis. Of these, 21% (35 patients) presented to their initial surgical consultation with AUB as the only chief complaint. The remaining 79% presented with other primary complaints, including pelvic pain (42%), dysmenorrhea (29%), infertility (7%), and dyschezia (1%). Among the 35 patients with AUB, most endorsed additional endometriosis-related symptoms when asked: 74% had concurrent dysmenorrhea, 40% dyspareunia, 31% chronic pelvic pain, 26% dyschezia, 17% dysuria, and 20% a history of infertility. Pathology findings revealed that 88% of these patients (n=35) had coexisting uterine abnormalities - 54% with leiomyoma, 11% with adenomyosis, and 23% with both. 9% had no identifiable uterine pathology, and 3% underwent uterine-sparing surgery. Conclusion: AUB was the primary presenting symptom in 21% of patients subsequently diagnosed with pathology-confirmed endometriosis, most of whom also endorsed hallmark endometriosis symptoms. Notably, 88% of these patients had coexisting leiomyoma, adenomyosis, or both, as confirmed by pathology. The high prevalence of coexisting uterine pathology may mask or divert attention from an underlying diagnosis of endometriosis. These findings underscore the need for broad symptom screening and maintaining a high index of suspicion for endometriosis in patients presenting with AUB, particularly when other chronic pelvic symptoms are also present.
Volume
32
Issue
11
First Page
S77
Last Page
S78
