title: Diameter of dominant leiomyoma is a possible determinant to predict coexistent endometriosis.
abstract: OBJECTIVE
  To identify the frequency and assess risk factors for unexpected discovery of peritoneal endometriotic implants in patients who underwent myomectomy or hysterectomy for symptomatic uterine leiomyomas.
  
  
  METHODS
  We retrospectively collected medical records of 829 patients with symptomatic leiomyomas in The University of Tokyo Hospital. All the patients underwent abdominal or laparoscopic surgeries between January 2001 and December 2010 and the presence or absence of endometriosis during surgery was analyzed. Possible determinant to predict coexistent endometriosis was statistically investigated.
  
  
  RESULTS
  In total, 105 leiomyoma cases (12.7% in 829 patients) were diagnosed with endometriosis. Patients with small dominant leiomyomas were significantly complicated by peritoneal endometriotic implants (small leiomyomas were classified as < 8 cm). The patients with both diagnoses were more likely to be infertile and at age 39 years or younger than those with leiomyoma alone.
  
  
  CONCLUSIONS
  Women undergoing myomectomy or hysterectomy with both endometriosis and leiomyomas have several different clinical features compared with women with only leiomyomas. The size of largest leiomyoma may provide an important clue for coexistent endometriosis. Women with substantial infertility despite a smaller leiomyomas burden may be more likely to have a surgical indication for concomitant endometriosis.
authors.affiliation: Department of Obstetrics and Gynecology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Isono
authors.forename: Osamu
authors.initials: O
authors.lastname: Wada-Hiraike
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Osuga
authors.forename: Tetsu
authors.initials: T
authors.lastname: Yano
authors.forename: Yuji
authors.initials: Y
authors.lastname: Taketani
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000175:diagnosis*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D018231:Leiomyomatosis / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D010532:Peritoneal Diseases / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014594:Uterine Neoplasms / Q000473:pathology* / Q000601:surgery; D014599:Uterus / Q000601:surgery