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29 - Pelvic pain, ovarian cysts and endometriosis in adolescent girls

from Part III - Management of specific disorders

Published online by Cambridge University Press:  04 May 2010

By
Paul L. Wood
Edited by
Adam H. Balen ,
Sarah M. Creighton ,
Melanie C. Davies ,
Jane MacDougall  and
Richard Stanhope
Paul L. Wood
Affiliation:
Kettering General Hospital, Kettering, UK
Adam H. Balen
Affiliation:
Leeds Teaching Hospitals, University Trust
Sarah M. Creighton
Affiliation:
University College London Hospitals
Melanie C. Davies
Affiliation:
University College London
Jane MacDougall
Affiliation:
Addenbrooke's Hospital, Cambridge
Richard Stanhope
Affiliation:
Great Ormond Street Hospital
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Summary

Introduction

The legacy of pelvic pathology and pelvic pain in adolescence is not inconsiderable in later life, with ramifications from both the actual pathological processes and their management. The main negative outcomes include subfertility, adhesion formation and chronic pelvic pain. Although these are in general well-recognized causative implications, the general awareness of their origins in the adolescent period is less well acknowledged. As a result, diagnosis may be delayed or treatment may be inappropriate, with consequent negative long-term outcomes for the individual. The lack of a consensus in the definition of chronic pelvic pain greatly hinders epidemiological studies. However, and despite limited data, the prevalence of chronic pelvic pain in the population appears to be high, with an annual prevalence in primary care in the UK of 38/1000 in women, a rate comparable to asthma (37/1000) and back pain (41/1000) (Zondervan & Barlow, 2000). The significance of two defined causes of pelvic pain in adolescence, endometriosis and ovarian cysts, will be explored first prior to an overall review of pelvic pain in this age group. The subject matter will nevertheless overlap throughout this chapter, given the inevitable close interrelationships that exist between pelvic pain, endometriosis and ovarian cysts. For instance, deep endometriosis, pelvic adhesions and ovarian cystic endometriosis are all independent predictors of pelvic pain (Porpora et al., 1999).

Type
Chapter
Information
Paediatric and Adolescent Gynaecology
A Multidisciplinary Approach
 , pp. 359 - 372
Publisher: Cambridge University Press
Print publication year: 2004

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References

Aboud, E (1997). A review of granulosa cell tumours and thecomas of the ovary. Arch Gynecol Obstet 2594, 161–165CrossRefGoogle Scholar
Ahmed, S (1999). Enlargement and maturation in benign cystic ovarian teratomata. Pediatr Surg Int 15, 435–436CrossRefGoogle Scholar
Almeida, O D Jr, Val-Gallas, J M, Browning, J L (1997). A protocol for conscious sedation in microlaparoscopy. J Am Assoc Gynecol Laparosc 4, 591–594CrossRefGoogle ScholarPubMed
*Audbert, A (2000). Characteristics of adolescent endometriosis. Gynecol Obstet Fertil 28, 450–454Google Scholar
Badawy, S Z, Prasad, M, Powers, C, Wojtowycz, A R (1997). Congenital cervicovaginal aplasia with septate uterus and functioning endometrium. J Pediatr Adolesc Gynecol 10, 213–217CrossRefGoogle ScholarPubMed
Balbi, C, Musone, R, Menditto, A et al. (2000). Influence of menstrual factors and dietary habits on menstrual pain in adolescence. Int J Obstet Gynecol Reprod Biol 91, 143–148CrossRefGoogle ScholarPubMed
Baraldi, R, Ghirardini, G (1998). Partial detachment of round ligament found at laparoscopy for chronic pain in a female adolescent. J Pediatr Adolesc Gynecol 11, 189–190CrossRefGoogle Scholar
Barnewolt, C E (1998). Imaging techniques to assess the pelvis in young females. Sem Pediatr Surg 7, 73–81CrossRefGoogle ScholarPubMed
Blumenthal, I, Kelleher, J, Littlewood, J (1981). Recurrent abdominal pain and lactose intolerance in childhood and adolescence. Br Med J 282, 2013–2014CrossRefGoogle Scholar
Blythe, M J (1998). Pelvic inflammatory disease in the adolescent population. Sem Pediatr Surg 7, 43–51CrossRefGoogle ScholarPubMed
Bodden-Heidrich, R, Busch, M, Kuppers, V, Beckmann, M W, Rechenberger, I, Bender, H G (1999). Chronic pelvic pain syndrome (CPPS), and chronic vulvar pain syndrome (CVPS), evaluation of psychosomatic aspects. J Psychosom Obstet Gynecol 20, 145–151CrossRefGoogle Scholar
Braverman, P K (2000). Sexually transmitted diseases in adolescents. Med Clinics N Am 84, 869–889CrossRefGoogle ScholarPubMed
*Breech, L L, Laufer, M R (1999). Obstructive anomalies of the female genital tract. J Reprod Med 44, 233–240Google Scholar
Brown, D L, Doubilet, P M, Miller, F H et al. (1998). Benign and malignant ovarian masses: selection of the most discriminating gray-scale and Doppler sonographic features. Radiology 208, 103–110CrossRefGoogle ScholarPubMed
Calaminus, G, Wessalowski, R, Harms, D, Gobel, U (1997). Juvenile granulosa cell tumours of the ovary in children and adolescents: results from 33 patients registered in a prospective cooperative study. Gynecol Oncol 65, 447–452CrossRefGoogle Scholar
Castile, R, Telander, R L, Cooney, D R et al. (1980). Crohn's disease in children: assessment of the progression of disease, growth and prognosis. J Paediatr Surg 15, 462–469CrossRefGoogle ScholarPubMed
Chao, K, Farrell, S, Kerdemelidis, P, Tulloh, B (1997). Diagnostic laparoscopy for chronic right iliac fossa pain: a pilot study. Aus N Z J Surg 67, 789–791CrossRefGoogle ScholarPubMed
Chen, F P, Soong, Y K, Lee, N, Lo, S K (1998). The use of serum CA-125 as a marker for endometriosis in patients with dysmenorrhoea for monitoring therapy and for recurrence of endometriosis. Acta Obstet Gynecol Scand 77, 665–670CrossRefGoogle ScholarPubMed
Coco, A S (1999). Primary dysmenorrhoea. Am Fam Physician 60, 489–496Google Scholar
Collett, B J, Cordle, C J, Stewart, C R, Jagger, C (1998). A comparative study of women with chronic pelvic pain, chronic non-pelvic pain and those with no history of pain attending general practitioners. Br J Obstet Gynaecol 105, 87–92CrossRefGoogle Scholar
Dadhwal, V, Mittal, S, Kumar, S, Barua, A (2000). Hematometra in postmenarchal adolescent girls: a report of two cases. Gynecol Obstet Invest 50, 67–69CrossRefGoogle ScholarPubMed
Demco, L (1998). Mapping the source and character of pain due to endometriosis by patient-assisted-laparoscopy. J Am Assoc Gynecol Laparosc 5, 241–245CrossRefGoogle ScholarPubMed
Eckler, K, Laufer, M R, Perlman, S E (2000). Conservative management of bilateral asynchronous adnexal torsion with necrosis in a prepubescent girl. J Pediatr Surg 35, 1248-1251CrossRefGoogle Scholar
Economy, K E, Laufer, M R (1999). Pelvic pain. Adolesc Med 10, 291–304Google ScholarPubMed
Elcombe, S, Gath, D, Day, A (1997). The psychological effects of laparoscopy on women with chronic pelvic pain. Psychol Med 27, 1041–1050CrossRefGoogle ScholarPubMed
Eltabbakh, G H, Kaiser, J R (2000). Laparoscopic management of a large ovarian cyst in an adolescent. A case report. J Reprod Med 45, 231–234Google Scholar
Emmert, C, Romann, D, Riedel, H H (1998). Endometriosis diagnosed by laparoscopy in adolescent girls. Arch Gynecol Obstet 261, 89–93CrossRefGoogle ScholarPubMed
Ezzat, A, Raja, M, Babri, Y et al. (1999). Malignant ovarian germ cell tumours — a survival and prognostic analysis. Acta Oncol 38, 455–460CrossRefGoogle ScholarPubMed
Fujimoto, V Y, Miller, J H, Klein, N A, Soules, M R (1997). Congenital cervical atresia: report of seven cases and review of the literature. Am J Obstet Gynecol 177, 1419–1425CrossRefGoogle ScholarPubMed
Geiger, J D, Coran, A G (1998). The association of large ovarian cysts with cloacal exstrophy. J Pediatr Surg 33, 719–721CrossRefGoogle ScholarPubMed
Gidwani, G (1989). Endometriosis: more common than you think. Contemp Pediatr 6, 99–110Google Scholar
Grazyna, M B, Malgorzata, J, Rzej, M, Marek, M, Marian, S (1998). Ovarian cysts in adolescent girls: report of 196 cases. Ginekol Pol 69, 1218–1222Google ScholarPubMed
Guerriero, S, Ajossa, S, Mais, V, Risalvato, A, Lai, M P, Melis, G B (1998). The diagnosis of endometriomas using colour Doppler energy imaging. Hum Reprod 13, 1691–1695CrossRefGoogle Scholar
Hansen, K A, Tho, S P, Hanly, M, Moretuzzo, R W, McDonough, P G (1997). Massive ovarian enlargement in primary hypothyroidism. Fertil Steril 67, 169–171CrossRefGoogle ScholarPubMed
Harris, R D, Holtzman, S R, Poppe, A M (2000). Clinical outcome in female patients with pelvic pain and normal pelvic US findings. Radiology 216, 440–443CrossRefGoogle ScholarPubMed
Hassan, E, Kontoravdis, A, Hassiakos, D, Kalogirou, D, Kontoravdis, N, Creatsas, G (1999). Evaluation of combined endoscopic and pharmaceutical management of endometriosis during adolescence. Clin Exp Obstet Gynecol 26, 85–87Google ScholarPubMed
Hawk, C, Long, C, Azad, A (1997). Chiropractic care for women with chronic pelvic pain: a prospective single-group intervention study. J Manip Physiol Ther 20, 73–79Google ScholarPubMed
Heim, C, Ehlert, U, Hanker, J P, Helhammer, D H (1998). Abuse-related posttraumatic stress disorder and alterations of the hypothalamic—pituitary—adrenal axis in women with chronic pelvic pain. Psychosom Med 60, 309–318CrossRefGoogle ScholarPubMed
Heinonen, P K (2000). Clinical implications of the didelphyic uterus: long-term follow-up of 49 cases. Int J Obstet Gynecol Reprod Biol 91, 183–190CrossRefGoogle ScholarPubMed
Hillen, T I, Grbavac, S L, Johnston, P J, Straton, J A, Keogh, J M (1999). Primary dysmenorrhoea in young Western Australian women: prevalence, impact and knowledge of treatment. J Adolesc Health 25, 40–45CrossRefGoogle Scholar
Hornstein, M D, Hemmings, R, Yupze, A A, Heinrichs, W L (1997). Use of nafarelin versus placebo after reductive laparoscopic surgery for endometriosis. Fertil Steril 68, 860-864CrossRefGoogle ScholarPubMed
Huang, A, Jay, M S, Uhler, M (1997). Tuboovarian abscess in the adolescent. J Pediatr Adolesc Gynecol 10, 73–77CrossRefGoogle ScholarPubMed
Jamieson, D J, Steege, J F (1997). The association of sexual abuse with pelvic pain complaints in a primary care population. Am J Obstet Gynecol 177, 1408–1412CrossRefGoogle Scholar
Jaszczynski, P, Adamek, K, Jawornik, M (1995). An enormous oviduct haematoma coexisting with a residual uterus horn in an adolescent. Gonekol Pol 66, 249–252Google Scholar
*Kanizsai, B, Orley, J, Szigetvari, I, Doszpod, J (1998). Ovarian cysts in children and adolescents: their occurrence, behavior, and management. J Pediatr Adolesc Gynecol 11, 85–88CrossRefGoogle ScholarPubMed
Kemper, K J, Sarah, R, Silver-Highfield, E, Xiarhos, E, Barnes, L, Berde, C (2000). On pins and needles? Pediatric pain patients' experience with acupuncture. Pediatrics 105, 941–947Google ScholarPubMed
Klein, T A, Richmond, J A, Mishell, D R Jr (1976). Pelvic tuberculosis. Obstet Gynecol 48, 99–104Google ScholarPubMed
Kontoravdis, A, Hassan, E, Hassiakos, D, Botsis, D, Kontoravdis, N, Creatsas, G (1999). Laparoscopic evaluation and management of chronic pelvic pain during adolescence. Clin Exp Obstet Gynecol 26, 76–77Google ScholarPubMed
Kozlowski, K J (1999). Ovarian masses. Adolesc Med 10, 337–350Google ScholarPubMed
Lampe, A, Solder, E, Ennemoser, A, Schubert, C, Rumpold, G, Sollner, W (2000). Chronic pelvic pain and previous sexual abuse. Obstet Gynecol 96, 929–933Google ScholarPubMed
Laufer, M R (1997). Identification of clear vesicular lesions of atypical endometriosis: a new technique. Fertil Steril 68, 739-740CrossRefGoogle ScholarPubMed
Laufer, M R, Goitein, L, Bush, M, Cramer, D W, Emans, S J (1997). Prevalence of endometriosis in adolescent girls with chronic pelvic pain not responding to conventional therapy. J Pediatr Adolesc Gynecol 10, 199–202CrossRefGoogle Scholar
Liang, C C, Soong, Y K, Ho, Y S (1995). Endometriosis in adolescent women. Chang Xue Zhi 18, 315–321Google ScholarPubMed
Leserman, J, Li, Z, Drossman, D A, Hu, Y J (1998). Selected symptoms associated with sexual and physical abuse history among female patients with gastrointestinal disorders: the impact on subsequent health care visits. Psychol Med 28, 417–425CrossRefGoogle ScholarPubMed
Lindheim, S R (1999). Chronic pelvic pain: presumptive diagnosis and therapy using GnRH agonists. Int J Fertil Womens Med 44, 131–138Google ScholarPubMed
Lineberry, T D, Rodriguez, H (2000). Isolated torsion of the fallopian tube in an adolescent: a case report. J Pediatr Adolesc Gynecol 13, 135–137CrossRefGoogle Scholar
Lubianca, J N, Gordon, C M, Laufer, M R (1998). ‘Add-back’ therapy for endometriosis in adolescents. J Reprod Med 43, 164–172Google ScholarPubMed
Mettler, L, Semm, K, Shive, K (1997). Endoscopic management of adnexal masses. J Soc Lap Surg 1, 103–112Google ScholarPubMed
Nezhat, C R, Nezhat, Kalyoncu C H, Johnson, E, Berlanda, N, Nezhat, F (1999). Laparoscopic management of ovarian dermoid cysts: ten years' experience. Soc Lap Surg 3, 179–184Google ScholarPubMed
Ozaksit, G, Caglar, T, Zorlu, C G et al. (1995). Chronic pelvic pain in adolescent women. Diagnostic laparoscopy and ultrasonography. J Reprod Med 40, 500–502Google ScholarPubMed
Papathanasiou, K, Papageorgiou, C, Panidis, D, Mantalenakis, S (1999). Our experience in laparoscopic diagnosis and management in women with chronic pelvic pain. Clin Exp Obstet Gynecol 26, 190–192Google ScholarPubMed
Perrin, L C, Low, J, Nicklin, J L, Ward, B G, Crandon, A J (1999). Fertility and ovarian function after conservative surgery for germ cell tumours of the ovary. Aus N Z J Obstet Gynaecol 39, 243–245Google ScholarPubMed
Poenaru, D, Jacobs, D A, Kamal, I (1999). Unusual findings in the inguinal canal: a report of four cases. Pediatr Surg Int 15, 515–516CrossRefGoogle ScholarPubMed
Polasek, P M, Erickson, L D, Stanhope, C R (1995). Transverse vaginal septum associated with tubal atresia. Mayo Clinic Proc 70, 965–968CrossRefGoogle ScholarPubMed
Porpora, M G, Koninckx, P R, Piazze, J, Natili, M, Colagrande, S, Cosmi, E V (1999). Correlation between endometriosis and pelvic pain. J Am Assoc Gynecol Laparosc 6, 429–434CrossRefGoogle ScholarPubMed
Powell, J L, Otis, C N (1997). Management of advanced juvenile granulosa cell tumour of the ovary. Gynecol Oncol 64, 282–284CrossRefGoogle Scholar
Powell, J L, Connor, G P, Henderson, G S (2001). Management of recurrent juvenile granulosa cell tumour of the ovary. Gynecol Oncol 81, 113–116CrossRefGoogle Scholar
Propst, A M, Laufer, M R (1999). Endometriosis in adolescents. Incidence, diagnosis and treatment. J Reprod Med 44, 751-758Google ScholarPubMed
Raziel, A, Mordechai, E, Friedler, S, Schachter, M, Pansky, M, Ron-El, R (1999). Isolated recurrent torsion of the Fallopian tube: case report. Hum Reprod 14, 3000–3001CrossRefGoogle ScholarPubMed
*Reed, B D, Haefner, H K, Punch, M R, Roth, R S, Gorenflow, D W, Gillespie, B W (2000). Psychosocial and sexual functioning in women with vulvodynia and chronic pelvic pain. A comparative evaluation. J Reprod Med 45, 624–632Google ScholarPubMed
Reese, K A, Reddy, S, Rock, J A (1996). Endometriosis in an adolescent population: the Emory experience. J Pediatr Adolesc Gynecol 9, 125–128CrossRefGoogle Scholar
Rickert, V I, Kozlowski, K J (2000). Pelvic pain. A SAFE approach. Obstet Gynecol Clinics North Am 27, 181–193CrossRefGoogle ScholarPubMed
Romanzi, L J, Groutz, A, Blaivas, J G (2000). Urethral diverticulum in women: diverse presentations resulting in diagnostic delay and mismanagement. J Urol 164, 428–433CrossRefGoogle ScholarPubMed
Rome, E S (1998). Pelvic inflammatory disease: the importance of aggressive treatment in adolescents. Cleveland Clinic J Med 65, 369–376CrossRefGoogle ScholarPubMed
Savage, P, Constenla, D, Fisher, C et al. (1998). Granulosa cell tumours of the ovary: demographics, survival and the management of advanced disease. Clin Oncol 10, 242–245CrossRefGoogle ScholarPubMed
Savidge, C J, Slade, P (1997). Psychological aspects of chronic pelvic pain. J Psychosom Res 42, 433–444CrossRefGoogle ScholarPubMed
Saw, E C, Smale, L E, Einstein, H, Huntington, R W Jr (1975). Female genital coccidioidomycosis. Obstet Gynecol 45, 199–202Google ScholarPubMed
Schaffer M (1995). Pelvic pain in girls and adolescents. In Proceedings of the Ⅺ World Congress of Paediatric and Adolescent Gynaecology, p. 130
Schroeder, B, Sanfilippo, J S (1999). Dysmenorrhoea and pelvic pain in adolescents. Pediatr Clinics N Am 46, 555–571CrossRefGoogle ScholarPubMed
Selfe, S A, Matthews, Z, Stones, R W (1998). J Womens Health 7, 1041–1048CrossRef
Simpson, J L, Elias, S, Malinak, L R, Buttram, V C Jr (1981). Hereditable aspects of endometriosis. 1. Genetic studies. Am J Obstet Gynecol 137, 327–331CrossRefGoogle Scholar
Shaw R W (1994). A Slide Atlas of Endometriosis. Parthenon, London
Stummvoll, W, Kapshammer, E (1999). Clinical aspects of endometriosis. Wein Med Wochenschr 149, 358–360Google ScholarPubMed
Tamura, M, Fukaya, T, Takaya, R, Ip, C W, Yajima, A (1996). Juvenile adenomyotic cyst of the corpus uteri with dysmenorrhoea. Tohoku J Exp Med 178, 339–344CrossRefGoogle Scholar
Tashiro, H, Katabuchi, H, Ohtake, H, Kaku, T, Ushio, Y, Okamura, H (1999). A follicle-stimulating hormone-secreting gonadotroph adenoma with ovarian enlargement in a 10-year old girl. Fertil Steril 72, 158–160CrossRefGoogle Scholar
Templeman, C, Fallat, M E, Blinchevsky, A, Hertwick, S P (2000). Noninflammatory ovarian masses in girls and young women. Obstet Gynecol 96, 229–233Google ScholarPubMed
*Ugur, M, Turan, C, Mungan, T et al. (1995). Endometriosis in association with Mullerian abnormalities. Gynecol Obstet Invest 40, 261–264CrossRefGoogle Scholar
Vercellini, P, Crosignani, P G, Fadini, R, Radici, E, Belloni, C, Sismondi, P (1999). A gonadotrophin-releasing hormone agonist compared with expectant management after conservative surgery for symptomatic endometriosis. Br J Obstet Gynaecol 106, 672–677CrossRefGoogle ScholarPubMed
Volpi, E, Grandis, T, Zucccaro, G, Vista, A, Sismondi, P (1995). Role of transvaginal ultrasound in the detection of endometriomata. J Clin Ultrasound 23, 163–167CrossRefGoogle ScholarPubMed
Wellbery, C (1999). Diagnosis and treatment of endometriosis. Am Fam Physician 60, 1752–62Google ScholarPubMed
Yamamoto, K, Mitsuhashi, Y, Takaike, T, Takase, K, Hoshiai, H, Noda, K (1997). Tubal endometriosis diagnosed within one month after menarche: case report. Tohoku J Exp Med 181, 385–387CrossRefGoogle ScholarPubMed
Zondervan, K, Barlow, D H (2000). Epidemiology of chronic pelvic pain. Best Practice Res Clin Obstet Gynaecol 14, 403–414CrossRefGoogle ScholarPubMed
Zondervan, K, Yudkin, P L, Vessey, M P, Dawes, M G, Barlow, D H, Kennedy, S H (1999). Patterns of diagnosis and referral in women consulting for chronic pelvic pain in UK primary care. Br J Obstet Gynecol 106, 1156–1161CrossRefGoogle ScholarPubMed
Zrubek, H, Sikorski, M, Nasser, M, Stachowicz, , Chil, A (1999). Endometriosis in adolescents and young women. Can we afford to delay the diagnosis?Ginekol Pol 70, 264–269Google Scholar
Zydowicz-Mucha, E, Palatynski, A, Mikaszewska-Pietraszun, J, Zawalski, W (1999). Laparoscopic evaluation of adolescent girls suffering from algomenorrhoea and acyclic pelvic pain. Ginekol Pol 70, 260–263Google Scholar

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