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Preoperative and Postoperative Clinical and Transvaginal Ultrasound Findings of Adenomyosis in Patients With Deep Infiltrating Endometriosis
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.
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“We experience that deep infiltrating endometriosis (DIE) without concomitant adenomyosis (AM) is rare. Lazzeri et al. made a similar observation in an Italian study [9].”
From Women with Endometriosis—Who Is at Risk for Complications Associated with Pregnancy and Childbirth? A Retrospective Case–Control Study (2024) · cites this paper as [9]
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Metadata
- Authors
- Lazzeri, L., Di Giovanni, A., Exacoustos, C., Tosti, C., Pinzauti, S., Malzoni, M., Petraglia, F., & Zupi, E.
- Affiliations
- University of Siena (IT)
- Corresponding author
- Lazzeri, Lucia
- Venue
- Reproductive Sciences
- Published
- 2014-08
- Volume
- 21
- Issue
- 8
- Pages
- 1027-1033
- ISSN
- 1933-7191 (ISSN-L)
- 1933-7205
- OpenAlex
- W2068290923
- Cited by
- 137
- References
- 44
- Citations by year
- 2026: 9 · 2025: 12 · 2024: 16 · 2023: 9 · 2022: 16 · 2021: 6 · 2020: 22 · 2019: 7 · 2018: 8 · 2017: 11 · 2016: 6 · 2015: 9 · 2014: 6
- FWCI
- 12.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Reproductive Sciences (publishedVersion)
- PubMed (publishedVersion)
- Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion)
- Florence Research (University of Florence) (submittedVersion)
- Use Siena air (University of Siena) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Keywords
- adenomyosis, deep infiltrating endometriosis, transvaginal ultrasound, preoperative diagnosis, postoperative symptoms, dysmenorrhea, dyspareunia, abnormal uterine bleeding, laparoscopic surgery
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