Document Detail

The influence of adenomyosis in patients laparoscopically treated for deep endometriosis.
MedLine Citation:
PMID:  18722969     Owner:  NLM     Status:  MEDLINE    
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.
Stefano Landi; Liliana Mereu; Giovanni Pontrelli; Ania Stepniewska; Luigi Romano; Saverio Tateo; Carlo Dorizzi; Luca Minelli
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of minimally invasive gynecology     Volume:  15     ISSN:  1553-4650     ISO Abbreviation:  -     Publication Date:    2008 Sep-Oct
Date Detail:
Created Date:  2008-08-25     Completed Date:  2009-01-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101235322     Medline TA:  J Minim Invasive Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  566-70     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Ospedale Sacro Cuore, Verona, Italy.
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MeSH Terms
Adenomyoma / complications,  surgery*
Case-Control Studies
Colon / surgery
Endometriosis / complications,  surgery*
Gynecologic Surgical Procedures
Infertility, Female / etiology
Laparoscopy / methods*
Patient Satisfaction
Pelvic Pain / etiology,  surgery*
Rectum / surgery
Retrospective Studies
Treatment Outcome

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