title: Co-existence of uterine myomas and endometriosis in women undergoing laparoscopic myomectomy: risk factors and surgical implications.
abstract: OBJECTIVE
  To investigate the prevalence of and explore risk factors for the coexistence of uterine myomas and endometriosis and to assess operative outcomes during laparoscopic myomectomy.
  
  
  METHODS
  Retrospective cohort study (Canadian Task Force classification II-2).
  
  
  METHODS
  Tertiary referral center in London, England.
  
  
  METHODS
  Two hundred twelve women undergoing laparoscopic myomectomy to treat symptomatic uterine myomas.
  
  
  METHODS
  Laparoscopic myomectomy.
  
  
  RESULTS
  Coexisting myomas and endometriosis were identified in 21.2% of patients. Endometriosis was more common in those with subfertility (44% vs 25.7%; p = .02) and less common in those with bleeding disorders (20% vs 45%; p = .003). Parity, location of myoma, and race/ethnicity affected risk of endometriosis, whereas size and number of myomas did not. Of patients with endometriosis, 42% underwent surgical treatment of endometriosis during myomectomy. Significantly more patients with endometriosis also underwent ovarian cystectomy than did those without endometriosis (15.6% vs 3%; p = .004). Operative time was similar in both groups (109.6 minutes vs 116.4 minutes; p = .83), as was estimated blood loss (271 mL vs 327 mL; p = .16).
  
  
  CONCLUSIONS
  A diagnosis of concomitant endometriosis should be considered, in particular in patients with subfertility and pain. This enables optimal preoperative counseling and consent for potential additional procedures such as treatment of endometriosis or ovarian cystectomy.
authors.affiliation: Northwick Park Hospital, North West London Hospitals NHS Trust, Harrow, Middlesex, London, England.
authors.forename: Kate
authors.initials: K
authors.lastname: Maclaran
authors.affiliation: Northwick Park Hospital, North West London Hospitals NHS Trust, Harrow, Middlesex, London, England.
authors.forename: Nilesh
authors.initials: N
authors.lastname: Agarwal
authors.affiliation: Whipps Cross University Hospital, Barts Health NHS Trust, Leytonstone, London, England. Electronic address: jimi@doctors.org.uk.
authors.forename: Funlayo
authors.initials: F
authors.lastname: Odejinmi
mesh_terms: D000328:Adult; D004715:Endometriosis / Q000453:epidemiology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000453:epidemiology / Q000209:etiology; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D007889:Leiomyoma / Q000453:epidemiology* / Q000601:surgery*; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D000267:Tissue Adhesions / Q000453:epidemiology / Q000209:etiology; D063186:Uterine Myomectomy / Q000009:adverse effects / Q000379:methods*; D014594:Uterine Neoplasms / Q000453:epidemiology* / Q000601:surgery*
keywords: Complications; Endometriosis; Fibroids; Laparoscopy; Leiomyoma; Myomas; Myomectomy