TITLE:
Internal and External Endometriosis: Epidemiological, Diagnostic and Therapeutic Aspects at the Dominique Ouattara Mother and Child Hospital, Bingerville, Côte d’Ivoire
AUTHORS:
Kouamé Arthur Didier, Koffi Soh Victor, Boussou Jean Chrisosotome, Yao Brou Alexis, Loba Okpoin José, Yao Konan Charles Hénoc N’guessan, Sonna Soptafo Alex Telesphore
KEYWORDS:
Endometriosis, Internal Endometriosis, Endometrioma, Côte d’Ivoire, Sub-Saharan Africa
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.16 No.10,
October
13,
2026
ABSTRACT: Background: Data on endometriosis in sub-Saharan Africa remain scarce. This study aimed to describe the epidemiological, clinical, diagnostic and therapeutic characteristics of women managed for internal and/or external endometriosis in a university hospital in Côte d’Ivoire. Methods: We conducted a retrospective descriptive study based on the medical records of women of reproductive age (15 - 49 years) managed for internal and/or external endometriosis at the Dominique Ouattara Mother and Child Hospital, Bingerville, from January 2018 to December 2023. Following the classical nomenclature, endometriosis was classified as internal (endometriosis interna, located within the myometrium) or external (located outside the uterus), and patients were classified into three groups: internal endometriosis only, external endometriosis only, or both. Results: A total of 205 patients were included, corresponding to a hospital-based frequency of 1.24% of the 16,487 women seen in gynecological consultations and emergencies. The mean age was 38.1 ± 6.1 years. Internal endometriosis alone was found in 85 patients (41.5%), external endometriosis alone in 63 (30.7%) and both forms in 57 (27.8%). The leading reason for consultation was a desire for pregnancy (45.9%), followed by pain (28.3%); 58.0% of patients reported at least one painful symptom and 27.8% had documented infertility. Ultrasound (77.6%) and magnetic resonance imaging (57.6%) were the main diagnostic investigations; histological examination was available for 18.0% of patients. The main external forms were ovarian endometrioma (36.6%) and deep endometriosis (17.6%). Medical treatment was given to 79.0% of patients, mainly gonadotropin-releasing hormone agonists, and 24.4% underwent surgery, by laparoscopy in 84.0% of cases; 22 of the 23 hysterectomies were performed in women with internal endometriosis. Conclusions: In this hospital series, internal endometriosis, alone or combined with external endometriosis, accounted for most cases, and the desire for pregnancy was the leading reason for consultation. Diagnosis relied mainly on imaging, with limited histological confirmation, and management was predominantly medical. Prospective studies using standardized diagnostic criteria are needed.