Abstract
Objective: To investigate the difference of clinical features and outcomes between EM patients with and without AM after following up for at least 6 years after surgery.Methods: We retrospectively analyzed 358 EM patients who had a minimum of 6 years follow-up after laparoscopic cystectomy, which was performed by one single doctor at Peking Union Medical College Hospital from January 2009 to April 2013. All women were divided into AM group and non-AM group and analysis was performed in preoperative characteristics, surgical findings and postoperative outcomes during follow-up.Results: A total of 358 EM patients were recruited, of which 142 (39.7%) were in the AM group and the rest 216 (60.3%) in the non-AM group. Between the two group, the mean age was 34.6 vs. 32.2 years (P < 0.001). The mean operating time in the AM and non-AM group was 73.2 vs. 61.9 min (P < 0.001). According to the revised AFS classification, the mean score of the two group were 60.3 vs. 45.5 (P < 0.001). At the end of the follow-up, though the AM group was with higher rate of disease relapse, yet no significant difference was found between the two groups in statistical comparison (34/142 [23.9%] vs. 34/216 [15.7%], P = 0.053). With a minimum follow-up of 6 years after laparoscopic cystectomy, failed and successful pregnancy were seen in 107/142(75.4%) and 35/142 (24.6%) patients in the AM group vs. 114/216(52.8%) and 102/216 (47.2%) patients in the non-AM group (P < 0.05). As for the successfully pregnant patients, live births, including spontaneous pregnancy and IVF-ET, were seen in 34/35 (97.1) vs. 99/102 (97.1) patients between AM and non-AM groups, while others ended in spontaneous abortion. No significant associations were found between the two groups in infertility, leiomyoma presence, the size of ovarian endometrioma, type of deep infiltrating endometriosis (DIE) or type of recurrence (P > 0.05).Conclusion: Compared with non-AM group, EM patients with concurrent AM may have higher age, longer mean operating time and higher mean AFS score. In terms of fertility outcomes, patients in the AM group were with lower likelihood of pregnancy after surgery during the long-time follow-up.
Highlights
Endometriosis (EM) is a benign gynecological disease characterized by the presence of endometrial-like tissue outside the uterine cavity [1]
We investigated the clinical features of patients with concurrent endometriosis and adenomyosis and all patients were followed up regularly for 6–10 years
We found that 39.7% of the patients with EM were with AM, which is in accordance with previous studies reporting that 34.6–79% of patients with EM could be combined with AM [4, 9, 18, 23]
Summary
Endometriosis (EM) is a benign gynecological disease characterized by the presence of endometrial-like tissue outside the uterine cavity [1]. For EM, endometriomas are very common type of EM occurring in 17–44% of women with EM, and laparoscopic cystectomy is known as the gold standard in diagnosis and the recommended first-line treatment [10,11,12]. For AM, most previous studies have assessed populations of women who underwent hysterectomy to report the prevalence of AM. There is still a lack of high-quality data evaluating EM patients concurrent with AM as for their clinical features and long-term postoperative outcomes. We evaluated the prevalence of AM in patients undergoing laparoscopic surgery for EM and investigated the clinical features and postoperative outcomes between EM patients with and without AM with a minimum follow-up of 6 years.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
