189 overall is different in the presence of endometriosis (232,245,253,254). When the menstrual phases are disregarded, a higher contraction frequency was observed in patients with endometriosis than in controls (253). Leyendecker et al. (1996) specifically investigated the contraction features through the menstrual cycle phases and found a higher contraction frequency in patients with endometriosis (n= 111) than in controls (n=94) across phases. Contraction frequency was especially increased in the follicular and mid-luteal phase (232). Contradictorily, Kido et al. (2007) found a decreased contraction frequency during the periovulatory phase in patients with endometrial cysts (n=26 vs. n=12) (245). A controlled prospective study contradicted these outcomes, showing that endometriosis had almost no influence on uterine contractions during the periovulatory phase. Endometriosis severity did not seem to affect contraction frequency (249). Contraction amplitude Bulletti et al. (1997) described a (non-significant) increased uterine amplitude in patients with endometriosis (n=16) compared to healthy women (n= 12) (253). Further research confirmed statistically significantly increased contraction amplitude in endometriosis patients (n=22 vs n=22) across menstrual cycle phases (254). Contraction direction Contraction direction in patients with endometriosis was only examined by two studies. One case-control study stated that patients with endometriosis (n=111) as well as healthy women (n=94) progressing through the menstrual cycle show a similar decrease in cervix-to-fundus directed contractions (232). A further case-control study focusing on the influence of endometriosis presenting as endometrioma’s, did report a difference versus healthy women, with statistically significantly fewer uterine contractions from cervix-to-fundus in endometriosis patients during the periovulatory phase (245). Additional peristaltic observations During the follicular phase, patients with endometriosis (n=111) demonstrated more of these dysperistaltic contractions compared to controls (n= 94) (232). In patients with endometriosis and additional adenomyosis (n=24/80), hyperperistalsis is seen in patients with an focal adenomyosis (n=14/80)
RkJQdWJsaXNoZXIy MTk4NDMw