Co-Existence of Uterine Myomas and Endometriosis in Women Undergoing Laparoscopic Myomectomy: Risk Factors and Surgical Implications

Kate Maclaran, Agarwal N, Nilesh Agarwal, Funlayo Odejinmi
Journal of Minimally Invasive Gynecology · 2014 · vol. 21(6) , pp. 1086–1090 · doi:10.1016/j.jmig.2014.05.013 · PMID:24905479 · W2079817579
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This study investigated the prevalence of endometriosis in women undergoing laparoscopic myomectomy for uterine fibroids and identified associated risk factors and surgical considerations.

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Abstract

Study objectiveTo investigate the prevalence of and explore risk factors for the coexistence of uterine myomas and endometriosis and to assess operative outcomes during laparoscopic myomectomy.DesignRetrospective cohort study (Canadian Task Force classification II-2).SettingTertiary referral center in London, England.PatientsTwo hundred twelve women undergoing laparoscopic myomectomy to treat symptomatic uterine myomas.InterventionLaparoscopic myomectomy.Measurements and main resultsCoexisting myomas and endometriosis were identified in 21.2% of patients. Endometriosis was more common in those with subfertility (44% vs 25.7%; p = .02) and less common in those with bleeding disorders (20% vs 45%; p = .003). Parity, location of myoma, and race/ethnicity affected risk of endometriosis, whereas size and number of myomas did not. Of patients with endometriosis, 42% underwent surgical treatment of endometriosis during myomectomy. Significantly more patients with endometriosis also underwent ovarian cystectomy than did those without endometriosis (15.6% vs 3%; p = .004). Operative time was similar in both groups (109.6 minutes vs 116.4 minutes; p = .83), as was estimated blood loss (271 mL vs 327 mL; p = .16).ConclusionsA diagnosis of concomitant endometriosis should be considered, in particular in patients with subfertility and pain. This enables optimal preoperative counseling and consent for potential additional procedures such as treatment of endometriosis or ovarian cystectomy.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometriosis Laparoscopy Laparoscopy Laparoscopy Leiomyoma Leiomyoma Uterine Myomectomy Uterine Neoplasms Uterine Neoplasms Adult Endometriosis Female Humans Infertility, Female Infertility, Female Infertility, Female Leiomyoma Operative Time Postoperative Complications

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