[Catamenial hemothorax: Results of 11 operated cases].

OBJECTIVE

To report our therapeutic approach toward catamenial hemothorax.

PATIENTS AND

METHODS

This retrospective study from January 1994 to November 2018 concerned patients operated under general anesthesia for catamenial hemothorax. A posterolateral thoracotomy approach was implemented either directly or after primary videothoracoscopy. Six-month hormone therapy was systematically prescribed postoperatively. The result was assessed in terms of occurrence or non-occurrence of hemothorax upon resumption of menses after discontinuation of hormone therapy.

RESULTS

Eleven patients were selected, with an average age was 32years (25-41). Catamenial hemothorax was associated with hemorrhagic ascites in 5 cases. Endometriotic plaques in the form of diaphragmatic fenestrations were found nine times and were resected (1 case) or covered by a synthetic non-absorbable patch (8 cases). Pleural symphysis completed the surgical procedures. The one hormone used was triptorelin. Mortality was zero. Mean postoperative hospital stay was 10.24days and mean follow-up was 3.5years. One patient was lost to follow-up at 3months. One hemothorax recurrence was observed after discontinuation of hormone therapy at 4months [1], and repeated pleural punctures were carried out while awaiting revision surgery. The five cases of ascites recurred and the patients were monitored in the gynecology unit.

CONCLUSION

In patients suffering from catamenial hemothorax with diaphragmatic fenestrations, we recommend phrenoplasty using synthetic patches associated with pleural talcage and 6-month complementary concomitant hormone therapy.