Adenomyosis is an independent risk factor for complications in deep endometriosis laparoscopic surgery

Meritxell Gràcia, Meritxell Gracia, Cristian de Guirior, Crístian de Guirior, Marta Valdés‐Bango, Marta Valdés-Bango, Mariona Rius, Cristina Ros, Isabel Matas, Marta Tortajada, María Ángeles Martínez-Zamora, Maria Ángeles Martínez‐Zamora, Lara Quintas, Francisco Carmona
Scientific reports · 2022 · vol. 12(1) , pp. 7086 · doi:10.1038/s41598-022-11179-8 · PMID:35490172 · W4225278611
article OA: gold CC0 ⤵ 13 in-corpus citations
📄 Open PDF View on OpenAlex View on PubMed View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

Adenomyosis is an independent preoperative risk factor for surgical complications in deep endometriosis laparoscopic surgery.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 ⓘ

This retrospective cohort study evaluated whether preoperative adenomyosis affected surgical complications in 157 women with deep endometriosis (DE) undergoing laparoscopic DE surgery at a referral center (2018–2019). Two expert sonographers diagnosed DE and adenomyosis preoperatively using International Deep Endometriosis Analysis criteria and Morphological Uterus Sonographic Assessment (MUSA) features, with adenomyosis defined by ≥3 MUSA criteria; surgical complications were graded using the Clavien–Dindo classification, and multivariate analysis adjusted for relevant demographic, clinical, and surgical factors. Adenomyosis was associated with a higher overall complication rate (33.76% with adenomyosis vs 12.50% without) and remained an independent risk factor for complications (4.56-fold increased risk), with the number of adenomyosis ultrasound criteria correlating with complication frequency; the paper’s caveat is that it is retrospective. This paper is centrally about endometriosis—specifically how adenomyosis predicts complications after laparoscopic surgery for deep endometriosis.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

Deep endometriosis (DE) occurs in 15-30% of patients with endometriosis and is associated with concomitant adenomyosis in around 25-49% of cases. There are no data about the effect of the presence of adenomyosis in terms of surgical outcomes and complications. Thus, the aim of the present study was to evaluate the impact of adenomyosis on surgical complications in women with deep endometriosis undergoing laparoscopic surgery. A retrospective cohort study including women referred to the endometriosis unit of a referral teaching hospital. Two expert sonographers preoperatively diagnosed DE and adenomyosis. DE was defined according to the criteria of the International Deep Endometriosis Analysis group. Adenomyosis was considered when 3 or more ultrasound criteria of the Morphological Uterus Sonographic Assessment group were present. Demographical variables, current medical treatment, symptoms, DE location, surgical time, hospital stay and difference in pre and post hemoglobin levels were collected. The Clavien-Dindo classification was used to assess surgical complications, and multivariate analysis was performed to compare patients with and without adenomyosis. 157 DE patients were included into the study; 77 (49.05%) had adenomyosis according to transvaginal ultrasound (TVS) and were classified in the A group, and 80 (50.95%) had no adenomyosis and were classified in the noA group. Adenomyosis was associated with a higher rate of surgical complications: 33.76% (A group) vs. 12.50% (noA group) (p < 0.001). Multivariate analysis showed a 4.56-fold increased risk of presenting complications in women with adenomyosis (CI 1.90-11.30; p = 0.001) independently of undergoing hysterectomy. There was a statistically significant association between the number of criteria of adenomyosis present in each patient and the proportion of patients presenting surgical complications (p < 0.001). Adenomyosis is an independent preoperative risk factor for surgical complications in DE surgery after adjustment for known demographic, clinical and surgical risk factors.

My notes (saved in your browser only)

Condition tags

mesh:D004715endometriosisadenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis

Citation neighborhood

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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (40)

Cited by (13)

Source provenance

europepmc
last seen: 2026-06-04T01:30:01.192114+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-06-04T00:34:54.200900+00:00
License: CC0 · commercial use OK