Coexistence of endometriomas with extraovarian endometriosis and adhesions

Elvin Piriyev, Schiermeier S, Sven Schiermeier, Römer T, Thomas Römer
European journal of obstetrics, gynecology, and reproductive biology · 2021 · vol. 263 , pp. 20–24 · doi:10.1016/j.ejogrb.2021.05.044 · PMID:34144489 · W3171778252
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This paper investigated endometriomas and their frequent association with extraovarian endometriosis and adhesions.

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Abstract

ObjectiveThe aim of the study is to show the coexistence of the endometriomas with peritoneal and deep infiltrating endometriosis, as well as with the adhesions. Study design It's a randomized retrospective study. Patients treated for endometrioma at Academic Hospital Cologne Weyertal from January 2014 to October 2019 were included. In total there were 1054 patients. 310 medical records were chosen at random without a special selection and the data were analysed.ResultsIn our study, endometriomas were alone, which means without extraovarian endometriosis and/or adhesions, in only 2.3% of the cases. In the total population, 80.6% (250) of the patients had peritoneal endometriosis, 43.2% (134) of the patients had deep infiltrating endometriosis and 38% (118) of the patients had peritoneal and deep infiltrating endometriosis. In our analysis we found that in unilateral endometriomas there is no relationship between endometrioma size and adnexal adhesions. The risk of Douglas obliteration increases with the size of the endometriomas in unilateral endometriomas. In bilateral endometriomas, the risk of a complex adhesions is independent of the size of the endometriomas and relevantly higher than in unilateral endometriomas (Douglas obliteration 31.5% vs 16%, bilateral adnexal adhesions 45.2% vs 21.1%). Unilateral adnexal adhesions occurred in bilateral endometriomas only in 13.7%.ConclusionEndometriomas are the relevant problem in gynaecological practice. It must be taken into account here that endometriomas usually occur with peritoneal endometriosis and that surgical therapy may be useful. However, adhesions and DIE are to be expected with surgical treatment, which could make the operation more difficult. Especially in large and bilateral endometriomas, a high coexistence with extraovarian endometriomas and adhesions is observed. Therefore, surgery should be performed by an experienced surgeon.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Endometriosis Ovarian Diseases Ovarian Diseases Ovarian Diseases Adnexa Uteri Female Humans Peritoneum Retrospective Studies Tissue Adhesions Tissue Adhesions

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