The influence of adenomyosis in patients laparoscopically treated for deep endometriosis

Stefano Landi, Landi S, Liliana Mereu, Pontrelli G, Giovanni Pontrelli, Ania Stepniewska, Anna Stepniewska, Romano L, Luigi Romano, Tateo S, Saverio Tateo, Carlo Dorizzi, Dorizzi C, Luca Minelli, Minelli L
Journal of Minimally Invasive Gynecology · 2008 · vol. 15(5) , pp. 566–570 · doi:10.1016/j.jmig.2008.06.009 · PMID:18722969 · W2088299087
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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 OBJECTIVE: A 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. DESIGN: Data were retrospectively collected from our computerized medical records (Canadian Task Force classification II-3). SETTING: General hospital. INTERVENTION: Restrospective evaluation. PATIENTS: From 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 RESULTS: In 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). CONCLUSION: Complete 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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Condition tags

endometriosischronic_pelvic_painadenomyosis

MeSH descriptors

Adenomyoma Endometriosis Laparoscopy Pelvic Pain Adenomyoma Adenomyoma Adenomyoma Adult Adult Case-Control Studies Case-Control Studies Colon Colon Colon Endometriosis Endometriosis Endometriosis Female Female Gynecologic Surgical Procedures

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 ]

References (26)

Cited by (22)

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