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 OBJECTIVE: To investigate the prevalence of and explore risk factors for the coexistence of uterine myomas and endometriosis and to assess operative outcomes during laparoscopic myomectomy. DESIGN: Retrospective cohort study (Canadian Task Force classification II-2). SETTING: Tertiary referral center in London, England. PATIENTS: Two hundred twelve women undergoing laparoscopic myomectomy to treat symptomatic uterine myomas. INTERVENTION: Laparoscopic myomectomy. MEASUREMENTS AND MAIN RESULTS: Coexisting 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). CONCLUSIONS: A 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 Laparoscopy Leiomyoma Leiomyoma Uterine Myomectomy Uterine Neoplasms Uterine Neoplasms Adult Adult Endometriosis Endometriosis Female Female Humans Humans Infertility, Female

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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