Lucia Lazzeri1, Alessandra Di Giovanni2, Caterina Exacoustos3, Claudia Tosti4, Serena Pinzauti4, Mario Malzoni2, Felice Petraglia4, Errico Zupi4. 1. Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy lucia.lazzeri@unisi.it lucialazzeri@email.it. 2. Advanced Gynecological Endoscopy Center, Malzoni Medical Center, Avellino, Italy. 3. Department of Obstetrics and Gynecology, University of Rome "Tor Vergata", Roma, Italy. 4. Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
Abstract
OBJECTIVES: Deep infiltrating endometriosis (DIE) represents the most complex form of endometriosis and its treatment is still challenging. The coexistence of DIE with other appearances of endometriosis stimulates new studies to improve the preoperative diagnosis. Adenomyosis is a clinical form that shares several symptoms with DIE. The present study investigated the possible presence of adenomyosis in a group of women with DIE and its impact on pre- and postoperative symptoms. MATERIALS AND METHODS: A group of women (n = 121) undergoing laparoscopic treatment for DIE were enrolled. Clinical and ultrasound evaluations were performed as preoperative assessment. The ultrasonographical appearances of DIE and of adenomyosis were recorded by 2-dimensional ultrasound. The following symptoms were considered: dysmenorrhea, dyspareunia, abnormal uterine bleeding, bowel, and urinary symptoms. Pain was evaluated by the visual analog scale system and menstrual bleeding was assessed by the use of the pictorial blood assessment chart. In a subgroup of women (n = 55), a follow-up evaluation (3-6 months after surgery) was done. RESULTS: A relevant number of patients with DIE showed adenomyosis (n = 59; 48.7%); in this group, dysmenorrhea (P = .0019), dyspareunia (P = .0004), and abnormal uterine bleeding (P < .001) were statistically higher than that in the group with only DIE. After surgery, painful symptoms improved in the whole group but remained significantly higher (P < .001) in the group with adenomyosis. CONCLUSIONS: Deep infiltrating endometriosis is frequently associated with adenomyosis, significantly affecting pre- and postoperative symptoms and thus influencing the follow-up management.
OBJECTIVES: Deep infiltrating endometriosis (DIE) represents the most complex form of endometriosis and its treatment is still challenging. The coexistence of DIE with other appearances of endometriosis stimulates new studies to improve the preoperative diagnosis. Adenomyosis is a clinical form that shares several symptoms with DIE. The present study investigated the possible presence of adenomyosis in a group of women with DIE and its impact on pre- and postoperative symptoms. MATERIALS AND METHODS: A group of women (n = 121) undergoing laparoscopic treatment for DIE were enrolled. Clinical and ultrasound evaluations were performed as preoperative assessment. The ultrasonographical appearances of DIE and of adenomyosis were recorded by 2-dimensional ultrasound. The following symptoms were considered: dysmenorrhea, dyspareunia, abnormal uterine bleeding, bowel, and urinary symptoms. Pain was evaluated by the visual analog scale system and menstrual bleeding was assessed by the use of the pictorial blood assessment chart. In a subgroup of women (n = 55), a follow-up evaluation (3-6 months after surgery) was done. RESULTS: A relevant number of patients with DIE showed adenomyosis (n = 59; 48.7%); in this group, dysmenorrhea (P = .0019), dyspareunia (P = .0004), and abnormal uterine bleeding (P < .001) were statistically higher than that in the group with only DIE. After surgery, painful symptoms improved in the whole group but remained significantly higher (P < .001) in the group with adenomyosis. CONCLUSIONS: Deep infiltrating endometriosis is frequently associated with adenomyosis, significantly affecting pre- and postoperative symptoms and thus influencing the follow-up management.
Authors: U Ulrich; O Buchweitz; R Greb; J Keckstein; I von Leffern; P Oppelt; S P Renner; M Sillem; W Stummvoll; R-L De Wilde; K-W Schweppe Journal: Geburtshilfe Frauenheilkd Date: 2014-12 Impact factor: 2.915
Authors: Vered H Eisenberg; Nissim Arbib; Eyal Schiff; Motti Goldenberg; Daniel S Seidman; David Soriano Journal: Biomed Res Int Date: 2017-09-18 Impact factor: 3.411
Authors: H Krentel; C Cezar; S Becker; A Di Spiezio Sardo; V Tanos; M Wallwiener; R L De Wilde Journal: Biomed Res Int Date: 2017-12-04 Impact factor: 3.411