The Influence of Adenomyosis in Patients Laparoscopically Treated for Deep Endometriosis
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This study investigated the impact of adenomyosis on outcomes for patients undergoing laparoscopic treatment for deep endometriosis.
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Abstract
Study objectiveA strong association exists between adenomyosis and endometriosis and a common pathogenetic mechanism was proposed. The aim of this study was to evaluate whether and how the presence of concurrent adenomyosis can affect the outcome of laparoscopic excision of deep endometriosis.DesignData were retrospectively collected from our computerized medical records (Canadian Task Force classification II-3).SettingGeneral hospital.InterventionRestrospective evaluation.PatientsFrom January 2003 through July 2005, 40 consecutive patients affected by concomitant endometriosis and adenomyosis were included in group A and another 40 affected by endometriosis only were included in group B.Measurements and main resultsIn group A, 20 women required bowel surgery (17 segmental and 3 full-thickness discoid resections) versus 16 patients in the other group (13 segmental bowel resections with end-to-end anastomosis and 3 discoid resections). Dysmenorrhea and dyspareunia after treatment improved (p<.01) in both groups, whereas dyschezia improved only in group A. The persistence of menometrorrhagia was more frequent in group B (p<.01). During follow-up, patients of group A underwent medical treatment for a longer time than those of group B (p<.001). Clinical detection of endometriosis recurrence was more frequent in patients with adenomyosis (p<.01), whereas no difference existed in the incidence of the recurrence detected by ultrasound. The overall number of pregnancies after surgery was significantly lower in the group with adenomyosis (p=.03).ConclusionComplete excision of deep endometriosis is not always feasible because of adenomyosis. For this reason, preoperative imaging screening for adenomyosis could be included in the preoperative workup when extensive disease is clinically suspected.
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Cited by (22)
- The role of levonorgestrel-releasing intrauterine system for recurrence prevention after conservative surgery among patients with coexistent ovarian endometrioma and diffuse adenomyosis: A retrospective case control study with long-term follow up 2023
- Adenomyosis and in vitro fertilization impacts - A literature review 2021
- Endometriosis and Risk of Adverse Pregnancy Outcome: A Systematic Review and Meta-Analysis 2021
- Does presence of adenomyosis affect reproductive outcome in IVF cycles? A retrospective analysis of 973 patients 2018
- Uterine adenomyosis and infertility, review of reproductive outcome after in vitro fertilization and surgery 2017
- Treatment options and reproductive outcome for adenomyosis-associated infertility 2017
- Prognostic factors for assisted reproductive technology in women with endometriosis-related infertility 2016
- Delivery and pregnancy outcome in women with bowel resection for deep endometriosis: a retrospective cohort study 2015
- Could the Uterine Junctional Zone be Used to Identify Early-Stage Endometriosis in Women? 2014
- Adenomyosis and reproductive performance after surgery for rectovaginal and colorectal endometriosis: a systematic review and meta-analysis 2014
- Systematic review of endometriosis pain assessment: how to choose a scale? 2014
- The uterine junctional zone: a 3-dimensional ultrasound study of patients with endometriosis 2013
- Patients with adenomyosis are more likely to have deep endometriosis 2012
- Effect of patient selection on estimate of reproductive success after surgery for rectovaginal endometriosis: literature review 2012
- Reply: Poor results after surgery for rectovaginal endometriosis can be related to uterine adenomyosis 2012
- Récidive de la douleur après chirurgie pour endométriose profonde : pourquoi ? Que faire ? 2012
- Adenomyosis and endometriosis have a common origin 2011
- Endométriose profonde et fertilité 2011
- Adenomyosis and junctional zone changes in patients with endometriosis 2011
- Is adenomyosis the neglected phenotype of an endomyometrial dysfunction syndrome? 2011
- Adenomiose em pacientes com endometriose profunda: aspectos clínicos, histológicos e radiológicos 2010
- Laparoscopic treatment of bowel endometriosis in infertile women 2009
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