Uterine adenomyosis in persistence of dysmenorrhea after surgical excision of pelvic endometriosis and colorectal resection.
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This study found that while endometriosis excision with bowel resection improved pelvic pain, dyspareunia, and GI symptoms, uterine adenomyosis not surgically addressed correlated with persistent dysmenorrhea.
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Abstract
OBJECTIVE: To determine whether the presence of uterine adenomyosis may impair the amelioration of pain symptoms after laparoscopic excision of pelvic endometriosis combined with colorectal resection. STUDY DESIGN: This prospective study included 50 women with bowel endometriosis with or without uterine adenomyosis. Presence of uterine adenomyosis was investigated by magnetic resonance imaging. Patients underwent excision of pelvic endometriosis and colorectal resection; some patients with focal adenomyosis underwent uterine surgery. Pain symptoms and gastrointestinal complaints were evaluated before surgery and at 6, 12 and 18 months' follow-up. RESULTS: At 6-month follow-up, dysmenorrhea significantly improved in women without uterine adenomyosis and in those with adenomyosis that was excised at surgery; this improvement persisted at 18 months' followup. No significant improvement in dysmenorrhea was observed in women with adenomyosis not excised at surgery. Deep dyspareunia and chronic pelvic pain significantly improved at follow-up in all study groups. Most of gastrointestinal symptoms improved or disappeared at 6 months' follow-up; the improvement in gastrointestinal function persisted at 18 months' follow-up. CONCLUSION: Excision of pelvic endometriosis combined with bowel resection significantly improves chronic pelvic pain, dyspareunia and gastrointestinal symptoms; however, the presence of uterine adenomyosis may determine persistence of dysmenorrhea.
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Cited by (28)
- Complex causal association between immunophenotypes and adenomyosis: Univariable, bidirectional, and multivariable Mendelian randomization 2025
- Excisional endometriosis surgery with hysterectomy and bilateral salpingo-oophorectomy versus excisional endometriosis surgery alone for pelvic pain associated with deep endometriosis 2023
- Prevalence of adenomyosis in women undergoing hysterectomy for abnormal uterine bleeding, pelvic pain or uterine prolapse – A retrospective cohort study 2022
- The Prevalence and Clinical Impact of Adenomyosis in Pregnancy-Related Hysterectomy 2022
- Associação entre os sintomas e a topografia das lesões da endometriose pélvica 2022
- Immune cells and Notch1 signaling appear to drive the epithelial to mesenchymal transition in the development of adenomyosis in mice 2021
- Adenomyosis: diagnostics and treatment 2020
- Immunological changes associated with adenomyosis: a systematic review 2020
- Transvaginal ultrasound-guided biopsy of adenomyosis 2019
- Deep Dyspareunia: Review of Pathophysiology and Proposed Future Research Priorities 2019
- From Clinical Symptoms to MR Imaging: Diagnostic Steps in Adenomyosis 2017
- Hysterectomy in the Surgical Management of Endometriosis 2017
- The Outcome on Conservative Surgical Treatment of Adenomyosis 2017
- Rectal shaving for deep endometriosis infiltrating the rectum: a 5-year continuous retrospective series 2016
- Endometriosis-related infertility: ovarian endometrioma<i>per se</i>is not associated with presentation for infertility 2016
- Deep endometriosis infiltrating the recto-sigmoid: critical factors to consider before management 2015
- Bowel Endometriosis: An Overview 2014
- Preoperative and Postoperative Clinical and Transvaginal Ultrasound Findings of Adenomyosis in Patients With Deep Infiltrating Endometriosis 2014
- How to Evaluate Adenomyosis in Patients Affected by Endometriosis? 2014
- Changes in the size of rectovaginal endometriotic nodules infiltrating the rectum during hormonal therapies 2012
- Reply: Poor results after surgery for rectovaginal endometriosis can be related to uterine adenomyosis 2012
- Bowel endometriosis: Recent insights and unsolved problems 2011
- Pharmacological treatment of endometriosis: update from recent clinical trials 2011
- Adenomyosis and junctional zone changes in patients with endometriosis 2011
- Multidetector computerized tomography enteroclysis vs. rectal water contrast transvaginal ultrasonography in determining the presence and extent of bowel endometriosis 2011
- Letrozole and norethisterone acetate in colorectal endometriosis 2010
- Progression of bowel endometriosis during treatment with the oral contraceptive pill 2010
- Norethisterone acetate in the treatment of colorectal endometriosis: a pilot study 2009
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