Catamenial pneumotorax as a manifestation of pulmonary forms of endometriosis

Catamenial pneumothorax (CP) is recurrent spontaneous pneumothorax that occurs in women during the reproductive period. According to its etiology, CP is a manifestation of the pulmonary forms of endometriosis (PE). Objective. To present clinical cases of PE-induced CP in the period 2015-2017 and the examination and management tactics elaborated by the authors for patients with this pathology Case reports. CP was detected and surgically treated in 3 patients because of PE only and that concurrent with genital forms of endometriosis. The paper gives the stages of a clinical diagnostic search for the diagnosis and identification of concurrent forms of endometriosis, surgical treatment, and drug therapy according to the patients’ reproductive plans. A multidisciplinary management approach is proposed to prevent the recurrence and progression of the disease within one-year follow-up after the onset of manifestation. Conclusion. The surgical management tactics for patients with CP due to PE involves thoracoscopy for pneumothorax, regardless of the presence or absence of evidence for bullous lung degeneration in reproductive- aged women, and removal of the cause of pneumothorax. The use of dienogest for medical correction in both pulmonary endometriosis only and that concurrent with pulmonary genital forms of endometriosis after surgical treatment is justified in order to prevent recurrent CP and progressive endometriosis. Dienogest is safe in its longterm use and the absence of severe side effects, which contributes to patient adherence to long-term treatment for the disease.

catamenial pneumothorax, pulmonary forms of endometriosis, infertility, spontaneous pneumothorax, intestinal endometriosis, dienogest, thoracoscopy