Table 2.
Univariate and multivariate logistic regression results for the surgically confirmed recurrent endometriosis analysis
| Non-endometriosis control | Single endometriosis diagnosis | Recurrent endometriosis | Non-endometriosis control vs recurrent endometriosis | Non-endometriosis control vs single endometriosis diagnosis | Single endometriosis diagnosis vs recurrent endometriosis | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Univariate analysis | Multivariate Lasso | Univariate analysis | Multivariate Lasso | Univariate analysis | Multivariate Lasso | |||||||
| OR (95% CI) | p value | Coef | OR (95% CI) | p value | Coef | OR (95% CI) | p value | Coef | ||||
| Age (years) | ||||||||||||
| n | 188 | 288 | 94 | |||||||||
| Mean (range) | 29.05 (18–50) | 29.17 (18–47) | 31.26 (18–45) | 0.017 | 0.854 | 0.008 | ||||||
| 18–24 (n, %) | 63 (33.5) | 76 (26.4) | 17 (18.1) | – | – | – | ||||||
| 25–29 (n, %) | 45 (23.9) | 95 (33.0) | 22 (23.4) | 1.81 (0.86–3.80) | 0.115 | 0.000 | 1.75 (1.08–2.85) | 0.024 | 0.219 | 1.04 (0.51–2.09) | 0.923 | −0.027 |
| 30–34 (n, %) | 39 (20.7) | 56 (19.4) | 25 (26.6) | 2.38 (1.14–4.95) | 0.021 | 0.000 | 1.19 (0.70–2.02) | 0.518 | 0.000 | 2.00 (0.98–4.04) | 0.055 | 0.000 |
| 35+ (n, %) | 41 (21.8) | 61 (21.2) | 30 (31.9) | 2.71 (1.33–5.53) | 0.006 | 0.131 | 1.23 (0.73–2.07) | 0.427 | 0.353 | 2.20 (1.11–4.36) | 0.024 | 0.000 |
| Past smokera | ||||||||||||
| No (n, %) | 111 (59.0) | 181 (62.8) | 46 (48.9) | |||||||||
| Yes (n, %) | 77 (41.0) | 107 (37.2) | 48 (51.1) | 1.50 (0.91–2.48) | 0.108 | 0.000 | 0.85 (0.58–1.24) | 0.405 | 0.000 | 1.77 (1.10–2.82) | 0.018 | 0.317 |
| Current smokera | ||||||||||||
| No (n, %) | 139 (73.9) | 221 (76.6) | 66 (70.2) | |||||||||
| Yes (n, %) | 49 (26.1) | 67 (23.3) | 28 (29.8) | 1.20 (0.69–2.08) | 0.509 | 0.000 | 0.86 (0.56–1.32) | 0.487 | −0.066 | 1.40 (0.83–2.35) | 0.205 | 0.000 |
| Never smokeda | ||||||||||||
| No (n, %) | 78 (41.5) | 107 (37.2) | 48 (51.1) | |||||||||
| Yes (n, %) | 110 (58.5) | 181 (62.8) | 46 (48.9) | 0.68 (0.41–1.12) | 0.128 | 0.000 | 1.20 (0.82–1.75) | 0.343 | 0.019 | 0.57 (0.35–0.91) | 0.018 | 0.000 |
| Age of menarche (years)a | ||||||||||||
| n | 188 | 287 | 94 | |||||||||
| Mean (range) | 12.57 (8–16) | 12.92 (8–19) | 12.46 (9–17) | 0.554 | 0.030 | 0.025 | ||||||
| Under 12 (n, %) | 47 (25.0) | 56 (19.5) | 24 (25.5) | – | – | – | ||||||
| 12–14 (n, %) | 121 (64.4) | 183 (63.8) | 63 (67.0) | 1.02 (0.57–1.82) | 0.947 | 0.000 | 1.27 (0.81–1.99) | 0.300 | 0.000 | 0.80 (0.46–1.40) | 0.441 | 0.000 |
| 15+ (n, %) | 20 (10.6) | 48 (16.7) | 7 (7.4) | 0.69 (0.25–1.85) | 0.455 | 0.000 | 2.01 (1.05–3.86) | 0.035 | 0.186 | 0.34 (0.13–0.86) | 0.023 | −0.435 |
| Graviditya | ||||||||||||
| n | 188 | 287 | 94 | |||||||||
| Mean (range) | 1.12 (0–11) | 0.43 (0–5) | 0.78 (0–5) | 0.109 | < 0.001 | 0.003 | ||||||
| 0 | 115 (61.2) | 210 (73.2) | 56 (59.6) | – | – | – | ||||||
| 1–2 | 37 (19.7) | 69 (24.0) | 29 (30.9) | 1.61 (0.90–2.88) | 0.109 | 0.000 | 1.02 (0.65–1.62) | 0.929 | 0.000 | 1.58 (0.93–2.66) | 0.089 | 0.000 |
| 3+ | 36 (19.1) | 8 (2.8) | 9 (9.6) | 0.51 (0.23–1.14) | 0.101 | −0.366 | 0.12 (0.05–0.27) | < 0.001 | −1.746 | 4.22 (1.56–11.43) | 0.005 | 0.535 |
| Paritya | ||||||||||||
| n | 188 | 287 | 94 | |||||||||
| Mean (range) | 0.56 (0–5) | 0.18 (0–4) | 0.42 (0–3) | 0.227 | < 0.001 | 0.002 | ||||||
| 0 | 135 (71.8) | 255 (88.9) | 68 (72.3) | – | – | – | ||||||
| 1–2 | 39 (20.7) | 29 (10.1) | 24 (25.5) | 1.22 (0.68–2.20) | 0.503 | 0.000 | 0.39 (0.23–0.66) | < 0.001 | −0.485 | 3.10 (1.70–5.67) | < 0.001 | 0.345 |
| 3+ | 14 (7.4) | 3 (1.0) | 2 (2.1) | 0.28 (0.06–1.28) | 0.102 | −0.048 | 0.11 (0.03–0.40) | 0.001 | 0.000 | 2.50 (0.41–15.26) | 0.321 | 0.000 |
| Systolic blood pressure (mmHg) | ||||||||||||
| n | 186 | 288 | 93 | |||||||||
| Mean (range) | 116.20 (89–159) | 114.40 (82–158) | 117.70 (90–152) | 0.414 | 0.136 | 0.039 | ||||||
| Under 120 | 115 (61.8) | 188 (65.3) | 59 (63.4) | – | – | – | ||||||
| 120–129 | 40 (21.5) | 69 (24.0) | 13 (14.0) | 0.63 (0.31–1.28) | 0.201 | 0.000 | 1.06 (0.67–1.66) | 0.816 | 0.076 | 0.60 (0.31–1.16) | 0.130 | −0.344 |
| 130–139 | 20 (10.8) | 19 (6.6) | 13 (14.0) | 1.27 (0.59–2.72) | 0.545 | 0.000 | 0.58 (0.30–1.14) | 0.112 | −0.154 | 2.18 (1.02–4.68) | 0.045 | 0.003 |
| 140+ | 11 (5.9) | 12 (4.2) | 8 (8.6) | 1.42 (0.54–3.71) | 0.478 | 0.000 | 0.67 (0.29–1.56) | 0.351 | 0.000 | 2.12 (0.83–5.44) | 0.117 | 0.000 |
| Diastolic blood pressure (mmHg) | ||||||||||||
| n | 186 | 288 | 93 | |||||||||
| Mean (range) | 73.16 (50–100) | 72.94 (48–106) | 74.63 (43–100) | 0.263 | 0.816 | 0.157 | ||||||
| Under 80 | 131 (70.4) | 214 (74.3) | 64 (68.8) | – | – | |||||||
| 80–84 | 33 (17.7) | 44 (15.3) | 12 (12.9) | 0.74 (0.36–1.54) | 0.425 | 0.000 | 0.82 (0.49–1.35) | 0.427 | 0.000 | 0.91 (0.45–1.83) | 0.795 | 0.000 |
| 85–89 | 13 (7.0) | 15 (5.2) | 5 (5.4) | 0.79 (0.27–2.30) | 0.662 | 0.000 | 0.71 (0.33–1.53) | 0.379 | 0.000 | 1.11 (0.39–3.18) | 0.840 | 0.000 |
| 90+ | 9 (4.8) | 15 (5.2) | 12 (12.9) | 2.73 (1.09–6.81) | 0.031 | 0.087 | 1.02 (0.43–2.40) | 0.963 | 0.000 | 2.67 (1.19–6.01) | 0.017 | 0.217 |
| BMI (kg/m2) | ||||||||||||
| n | 188 | 288 | 94 | |||||||||
| Mean (range) | 26.71 (16.05–49.02) | 24.56 (15.43–47.90) | 26.22 (17.23–50.44) | 0.513 | < 0.001 | 0.011 | ||||||
| Normal (18.5–24.9 kg/m2) | 87 (46.3) | 173 (60.1) | 44 (46.8) | – | – | |||||||
| Underweight (< 18.5 kg/m2) | 2 (1.1) | 14 (4.9) | 5 (5.3) | 4.94 (0.92–26.51) | 0.062 | 0.000 | 3.52 (0.78–15.84) | 0.101 | 0.539 | 1.40 (0.48–4.11) | 0.535 | 0.000 |
| Pre-obese (25–29.9 kg/m2) | 49 (26.1) | 66 (22.9) | 22 (23.4) | 0.89 (0.48–1.65) | 0.707 | 0.000 | 0.68 (0.43–1.06) | 0.090 | −0.108 | 1.31 (0.73–2.35) | 0.365 | 0.000 |
| Obese (≥ 30 kg/m2) | 50 (26.6) | 35 (12.2) | 23 (24.5) | 0.91 (0.49–1.68) | 0.762 | 0.000 | 0.35 (0.21–0.58) | < 0.001 | −0.885 | 2.58 (1.39–4.81) | 0.003 | 0.217 |
| Severe menstrual paina | ||||||||||||
| No (n, %) | 11 (5.9) | 20 (6.9) | 5 (5.3) | |||||||||
| Yes (n, %) | 177 (94.1) | 268 (93.1) | 89 (94.7) | 1.11 (0.37–3.28) | 0.856 | 0.000 | 0.83 (0.39–1.78) | 0.637 | 0.000 | 1.33 (0.48–3.64) | 0.581 | 0.000 |
| Severe pelvic pain (non-menstrual)a | ||||||||||||
| No (n, %) | 28 (14.9) | 62 (21.5) | 13 (13.8) | |||||||||
| Yes (n, %) | 160 (85.1) | 226 (78.5) | 81 (86.2) | 1.09 (0.54–2.22) | 0.811 | 0.000 | 0.64 (0.39–1.04) | 0.072 | −0.190 | 1.71 (0.89–3.27) | 0.106 | 0.107 |
| Dyspareuniaa | ||||||||||||
| No (n, %) | 38 (20.2) | 78 (27.1) | 20 (21.3) | |||||||||
| Yes (n, %) | 150 (79.8) | 210 (72.9) | 74 (78.7) | 0.94 (0.51–1.72) | 0.835 | 0.000 | 0.68 (0.44–1.06) | 0.089 | −0.122 | 1.37 (0.79–2.40) | 0.264 | 0.000 |
| Attendance at an emergency room for menstrual/pelvic paina | ||||||||||||
| No (n, %) | 131 (69.7) | 178 (61.8) | 45 (47.9) | |||||||||
| Yes (n, %) | 57 (30.3) | 110 (38.2) | 49 (52.1) | 2.50 (1.50–4.17) | < 0.001 | 0.523 | 1.42 (0.96–2.10) | 0.079 | 0.366 | 1.76 (1.10–2.82) | 0.018 | 0.170 |
| Currently taking hormone medicationa | ||||||||||||
| No (n, %) | 95 (50.5) | 181 (62.8) | 62 (66.0) | |||||||||
| Yes (n, %) | 93 (49.5) | 107 (37.2) | 32 (34.0) | 0.53 (0.32–0.88) | 0.015 | −0.262 | 0.60 (0.42–0.88) | 0.008 | −0.482 | 0.87 (0.54–1.42) | 0.586 | 0.000 |
| Previous hysterectomya | ||||||||||||
| No (n, %) | 187 (99.5) | 288 (100.0) | 90 (95.7) | |||||||||
| Yes (n, %) | 1 (0.5) | 0 (0.0) | 4 (4.3) | 8.31 (0.92–75.44) | 0.060 | 0.000 | N/A | N/A | ||||
| Ovarian cystsa | ||||||||||||
| No (n, %) | 108 (57.4) | 153 (53.) | 38 (40.4) | |||||||||
| Yes (n, %) | 80 (42.7) | 135 (46.9) | 56 (59.6) | 1.99 (1.20–3.29) | 0.007 | 0.119 | 1.19 (0.82–1.73) | 0.355 | 0.000 | 1.67 (1.04–2.68) | 0.033 | 0.000 |
| Fibrocystic breastsa | ||||||||||||
| No (n, %) | 176 (93.6) | 275 (95.5) | 88 (93.6) | |||||||||
| Yes (n, %) | 12 (6.4) | 13 (4.5) | 6 (6.4) | 1.00 (0.36–2.75) | 1.000 | 0.000 | 0.69 (0.31–1.55) | 0.374 | −0.414 | 1.44 (0.53–3.91) | 0.471 | 0.000 |
| Uterine fibroidsa | ||||||||||||
| No (n, %) | 169 (89.9) | 276 (95.8) | 82 (87.2) | |||||||||
| Yes (n, %) | 19 (10.1) | 12 (4.2) | 12 (12.8) | 1.30 (0.60–2.81) | 0.502 | 0.000 | 0.39 (0.18–0.82) | 0.013 | −0.508 | 3.37 (1.46–7.78) | 0.004 | 0.727 |
| Polycystic ovary diseasea | ||||||||||||
| No (n, %) | 148 (78.7) | 236 (81.9) | 73 (77.7) | |||||||||
| Yes (n, %) | 40 (21.3) | 52 (18.1) | 21 (22.3) | 1.06 (0.59–1.94) | 0.838 | 0.000 | 0.82 (0.51–1.29) | 0.385 | 0.000 | 1.31 (0.74–2.31) | 0.360 | 0.000 |
| Adenomyosisa | ||||||||||||
| No (n, %) | 181 (96.3) | 275 (95.5) | 74 (78.7) | |||||||||
| Yes (n, %) | 7 (3.7) | 13 (4.5) | 20 (21.3) | 6.99 (2.83–17.23) | < 0.001 | 1.356 | 1.22 (0.48–3.12) | 0.675 | 0.217 | 5.72 (2.72–12.03) | < 0.001 | 1.250 |
| Pre-cancer of the cervix or an abnormal Papanicolaou testa | ||||||||||||
| No (n, %) | 180 (95.7) | 274 (95.1) | 85 (90.4) | |||||||||
| Yes (n, %) | 8 (4.3) | 14 (4.9) | 9 (9.6) | 2.38 (0.89–6.39) | 0.085 | 0.000 | 1.15 (0.47–2.80) | 0.758 | 0.000 | 2.07 (0.87–4.96) | 0.102 | 0.339 |
| Cervical intraepithelial neoplasia (CIN) (pathology) | ||||||||||||
| No (n, %) | 171 (91.0) | 259 (89.9) | 77 (81.9) | |||||||||
| Yes (n, %) | 17 (9.0) | 29 (10.1) | 17 (18.1) | 2.22 (1.08–4.58) | 0.031 | 0.184 | 1.13 (0.60–2.11) | 0.711 | 0.000 | 1.97 (1.03–3.78) | 0.041 | 0.456 |
| Food allergies or intolerancesa | ||||||||||||
| No (n, %) | 143 (76.1) | 222 (77.1) | 66 (70.2) | |||||||||
| Yes (n, %) | 45 (23.9) | 66 (22.9) | 28 (29.8) | 1.35 (0.77–2.35) | 0.291 | 0.000 | 0.94 (0.61–1.46) | 0.797 | 0.000 | 1.43 (0.85–2.40) | 0.181 | 0.127 |
| Disturbance to taste or smella | ||||||||||||
| No (n, %) | 173 (92.0) | 273 (94.8) | 82 (87.2) | |||||||||
| Yes (n, %) | 15 (8.0) | 15 (5.2) | 12 (12.8) | 1.69 (0.76–3.77) | 0.202 | 0.000 | 0.63 (0.30–1.33) | 0.227 | 0.000 | 2.66 (1.20–5.92) | 0.016 | 0.203 |
| Hay fevera | ||||||||||||
| No (n, %) | 106 (56.4) | 182 (63.2) | 45 (47.9) | |||||||||
| Yes (n, %) | 82 (43.6) | 106 (36.8) | 49 (52.1) | 1.41 (0.86–2.31) | 0.177 | 0.199 | 0.75 (0.52–1.10) | 0.138 | −0.255 | 1.87 (1.17–2.99) | 0.009 | 0.460 |
| Eczemaa | ||||||||||||
| No (n, %) | 146 (77.7) | 198 (68.8) | 72 (76.6) | |||||||||
| Yes (n, %) | 42 (22.3) | 90 (31.3) | 22 (23.4) | 1.06 (0.59–1.91) | 0.841 | 0.000 | 1.58 (1.03–2.41) | 0.034 | 0.322 | 0.67 (0.39–1.15) | 0.148 | −0.279 |
| Previous diagnosis of endometriosisa | ||||||||||||
| No (n, %) | 188 (100.0) | 288 (100.0) | 19 (20.2) | |||||||||
| Yes (n, %) | 0 (0.0) | 0 (0.0) | 75 (79.8) | N/A | N/A | N/A | ||||||
| Family history of endometriosisa | ||||||||||||
| No (n, %) | 138 (74.2) | 215 (74.9) | 64 (68.1) | |||||||||
| Yes (n, %) | 48 (25.8) | 72 (25.1) | 30 (31.9) | 1.35 (0.78–2.32) | 0.282 | 0.000 | 0.96 (0.63–1.47) | 0.861 | 0.000 | 1.40 (0.84–2.33) | 0.196 | 0.145 |
| rASRM score | ||||||||||||
| n | 288 | 94 | ||||||||||
| Mean (range) | N/A | 14.32 (1–134) | 27.45 (1–142) | N/A | N/A | < 0.001 | 0.001 | |||||
| Stage of endometriosis (rASRM) | ||||||||||||
| Stage 1 (n, %) | 181 (62.8) | 36 (38.3) | – | |||||||||
| Stage 2 (n, %) | 42 (14.9) | 20 (21.3) | 2.34 (1.23–4.43) | 0.009 | 0.394 | |||||||
| Stage 3 (n, %) | N/A | 30 (10.4) | 12 (12.8) | 2.01 (0.94–4.30) | 0.071 | 0.000 | ||||||
| Stage 4 (n, %) | 34 (11.8) | 26 (27.7) | N/A | N/A | 3.84 (2.06–7.17) | < 0.001 | 0.000 | |||||
| Adhesions (surgical) | ||||||||||||
| No (n, %) | 150 (79.8) | 191 (66.3) | 36 (38.3) | |||||||||
| Yes (n, %) | 38 (20.2) | 97 (33.7) | 58 (61.7) | 6.36 (3.68–10.99) | < 0.001 | 1.524 | 2.00 (1.30–3.09) | 0.002 | 0.408 | 3.17 (1.96–5.14) | < 0.001 | 0.715 |
| Superficial ovarian lesion(s) | ||||||||||||
| No (n, %) | 251 (87.2) | 78 (83.0) | ||||||||||
| Yes (n, %) | N/A | 37 (12.8) | 16 (17.0) | N/A | N/A | 1.39 (0.73–2.64) | 0.311 | 0.000 | ||||
| Deep ovarian lesion(s) | ||||||||||||
| No (n, %) | 225 (78.1) | 70 (74.5) | ||||||||||
| Yes (n, %) | N/A | 63 (21.9) | 24 (25.5) | N/A | N/A | 1.22 (0.71–2.10) | 0.463 | −0.192 | ||||
| Superficial peritoneal lesion(s) | ||||||||||||
| No (n, %) | 32 (11.1) | 19 (20.2) | ||||||||||
| Yes (n, %) | N/A | 256 (88.9) | 75 (79.8) | N/A | N/A | 0.49 (0.26–0.92) | 0.026 | 0.000 | ||||
| Deep peritoneal lesion(s) | ||||||||||||
| No (n, %) | 209 (72.6) | 55 (58.5) | ||||||||||
| Yes (n, %) | N/A | 79 (27.4) | 39 (41.5) | N/A | N/A | 1.88 (1.15–3.05) | 0.011 | 0.000 | ||||
| Pouch of Douglas | ||||||||||||
| No (n, %) | 126 (43.8) | 35 (37.2) | ||||||||||
| Yes (n, %) | N/A | 162 (56.3) | 59 (62.8) | N/A | N/A | 1.31 (0.81–2.12) | 0.267 | 0.000 | ||||
| UV pouch | ||||||||||||
| No (n, %) | 215 (74.7) | 64 (68.1) | ||||||||||
| Yes (n, %) | N/A | 73 (25.3) | 30 (31.9) | N/A | N/A | 1.38 (0.83–2.30) | 0.214 | 0.008 | ||||
| Bladder | ||||||||||||
| No (n, %) | 287 (99.7) | 92 (97.9) | ||||||||||
| Yes (n, %) | N/A | 1 (0.3) | 2 (2.1) | N/A | N/A | 6.24 (0.56–69.60) | 0.137 | 0.699 | ||||
| Bowel | ||||||||||||
| No (n, %) | 256 (88.9) | 66 (70.2) | ||||||||||
| Yes (n, %) | N/A | 32 (11.1) | 28 (29.8) | N/A | N/A | 3.39 (1.91–6.03) | < 0.001 | 0.691 | ||||
| Tubes | ||||||||||||
| No (n, %) | 273 (94.8) | 86 (91.5) | ||||||||||
| Yes (n, %) | N/A | 15 (5.2) | 8 (8.5) | N/A | N/A | 1.69 (0.69–4.13) | 0.247 | 0.000 | ||||
| Pelvic side wall | ||||||||||||
| No (n, %) | 94 (32.6) | 32 (34.0) | ||||||||||
| Yes (n, %) | N/A | 194 (67.4) | 62 (66.0) | N/A | N/A | 0.94 (0.57–1.54) | 0.802 | 0.000 | ||||
| Pararectal space | ||||||||||||
| No (n, %) | 245 (85.1) | 87 (92.6) | ||||||||||
| Yes (n, %) | N/A | 43 (14.9) | 7 (7.4) | N/A | N/A | 0.46 (0.20–1.06) | 0.067 | −0.371 | ||||
| Uterosacral ligament | ||||||||||||
| No (n, %) | 154 (53.5) | 56 (59.6) | ||||||||||
| Yes (n, %) | N/A | 134 (46.5) | 38 (40.4) | N/A | N/A | 0.78 (0.49–1.25) | 0.302 | −0.074 | ||||
| Other | ||||||||||||
| No (n, %) | 215 (74.7) | 68 (72.3) | ||||||||||
| Yes (n, %) | N/A | 73 (25.3) | 26 (27.7) | N/A | N/A | 1.13 (0.67–1.90) | 0.657 | 0.000 | ||||
aPatient reported variable