title: The influence of adenomyosis in patients laparoscopically treated for deep endometriosis.
abstract: 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.
  
  
  METHODS
  Data were retrospectively collected from our computerized medical records (Canadian Task Force classification II-3).
  
  
  METHODS
  General hospital.
  
  
  METHODS
  Restrospective evaluation.
  
  
  METHODS
  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.
  
  
  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).
  
  
  CONCLUSIONS
  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.
authors: Department of Obstetrics and Gynecology, Ospedale Sacro Cuore, Verona, Italy.
authors: Stefano
authors: S
authors: Landi
authors: Liliana
authors: L
authors: Mereu
authors: Giovanni
authors: G
authors: Pontrelli
authors: Ania
authors: A
authors: Stepniewska
authors: Luigi
authors: L
authors: Romano
authors: Saverio
authors: S
authors: Tateo
authors: Carlo
authors: C
authors: Dorizzi
authors: Luca
authors: L
authors: Minelli
mesh_terms: D018194:Adenomyoma / Q000150:complications / Q000601:surgery*; D000328:Adult; D016022:Case-Control Studies; D003106:Colon / Q000601:surgery; D004715:Endometriosis / Q000150:complications / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007247:Infertility, Female / Q000209:etiology; D010535:Laparoscopy / Q000379:methods*; D017060:Patient Satisfaction; D017699:Pelvic Pain / Q000209:etiology / Q000601:surgery*; D012007:Rectum / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome