Anterior Focal Adenomyosis and Bladder Deep Infiltrating Endometriosis: Is There a Link?

Marcellin, Louis; Santulli, Piétro; Bortolato, Sara; Morin, Cécile; Millischer, A.; Borghese, Bruno; Chapron, Charles

doi:10.1016/j.jmig.2018.02.002

Cited by 36 publications

(24 citation statements)

References 26 publications

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“…68,69 Restricting to women with deep infiltrating endometriosis, overall adenomyosis prevalence is similarly high (35-78%), 65,70,71 with the highest prevalence reported for focal adenomyosis of the outer myometrium (49-97%). 65,72,73…”

Section: Prevalence In Women With Other Uterine-related Conditionsmentioning

confidence: 99%

Epidemiology of Adenomyosis

Upson

Missmer

2020

Semin Reprod Med

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Adenomyosis, characterized by the presence of endometrial glands and stroma within the myometrium, can have a substantial impact on the quality of women's lives. Despite this, the epidemiologic research on this condition lags considerably behind that of other noncancerous reproductive health conditions. The lack of progress and knowledge is due in part to the challenges in designing valid epidemiologic studies, since the diagnosis of adenomyosis historically has been limited to the examination of uterine specimens from hysterectomy. This review describes the available data on the frequency of this condition and the epidemiologic investigation thus far into the risk factors for disease—highlighting the methodologic and inference challenges primarily around study sample selection. We conclude with providing recommendations for approaches to future epidemiologic study that capitalize on the advancements in imaging technology to detect adenomyosis and provide a fuller picture of the occurrence and risk factors for disease.

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Section: Prevalence In Women With Other Uterine-related Conditionsmentioning

confidence: 99%

Epidemiology of Adenomyosis

Upson

Missmer

2020

Semin Reprod Med

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“…1). When outer myometrial adenomyosis exists in isolation it has been hypothesized that it may occur secondary to invasion of endometriosis, either from posterior or anterior sources (52). Relatively recent genetic evidence suggests that there are more than 1,000 abnormally up-regulated or downregulated genes in the eutopic endometrium of women with adenomyosis when compared with controls (53).…”

Section: Adenomyosismentioning

confidence: 99%

Uterine polyps, adenomyosis, leiomyomas, and endometrial receptivity

Munro

2019

Fertility and Sterility

154

103

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Endometrial polyps, adenomyosis, and leiomyomas are commonly encountered abnormalities frequently found in both fertile women and those with infertility. The clinician is frequently challenged to determine which of these entities, when found, is likely to impair fertility, and which are ''innocent bystanders'' unrelated to the problem at hand. Although removing an endometrial polyp may be seen as a relatively benign and safe intervention, myomectomy, and in particular adenomyomectomy, can be substantive surgical procedures, associated with their own potential for disrupting fertility. One of the mechanisms thought to be involved when these entities are contributing to infertility is an adverse impact on endometrial receptivity. Indeed polyps, adenomyosis, and leiomyomas have all been associated with an increased likelihood of abnormal endometrial molecular expressions thought to impair implantation and early embryo development. This review is designed to examine the relationship of these common entities to endometrial receptivity and to identify evidence gaps that should be considered when strategizing research initiatives. It is apparent that we have the tools necessary to fill these gaps, but it will be necessary to approach the issue in a strategic and coordinated fashion. It is likely that we will have to recognize the limitations of imaging alone and look to the evidence-based addition of molecular analysis to provide the individualized phenotyping of disease necessary for patient-specific treatment decisions. (Fertil Steril Ò 2019;111:629-40. Ó2019 by American Society for Reproductive Medicine.

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“…All underwent complete surgical excision of endometriosis lesions by laparoscopy or laparotomy, decided in multidisciplinary meetings, during the study period at our institution. Indications for surgery were: (1) gynaecological symptoms including severe chronic pelvic pain, defined as the presence of severe dysmenorrhoea, and/or severe intermenstrual pelvic pain and/or severe dyspareunia for at least 6 months; (2) gastrointestinal symptoms including painful constipation, rectal bleeding, and dyschezia, with or without menstrual exacerbation; (3) perineal neuropathic pain or sciatica; and (4) severe lower urinary tract symptoms defined as one or more of the following symptoms, either chronic or during menstruation: haematuria, recurrent urinary tract infection, painful urination, pollakiuria, and dysuria, with or without ureteral obstruction with ureterohydronephrosis …”

Section: Methodsmentioning

confidence: 99%

Associated ileocaecal location is a marker for greater severity of low rectal endometriosis

Marcellin

Leconte

Gaujoux

et al. 2019

BJOG

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Objective To determine whether ileocaecal endometriosis (ICE) is a marker for low rectal endometriosis (LRE) severity.Design Retrospective cohort study. Setting France.Population and sample Analysis of 375 colorectal resections performed in women undergoing complete surgery for LRE from January 1995 to December 2015 in a university centre for endometriosis.Methods Univariate and multivariate analysis of anatomical, postoperative clinical, and long-term outcomes according to presence of ICE.Main outcomes and measures Mean number and type of deep infiltrating endometriosis (DIE) lesions, the existence of an associated endometrioma, and mean total American Society for Reproductive Medicine (ASRM) score.Results The prevalence of ICE was 25.6%. Primary end-point data showed that women with ICE had a significantly higher adjusted number of DIE lesions (OR = 1.43, 95% CI 1.02-3.03; P = 0.048), higher prevalence of endometriomas (OR = 1.91, 95% CI 1.04-3.51; P = 0.044), more associated DIE sigmoid lesions (OR = 2.12, 95% CI 1.07-3.91; P = 0.025), and a higher mean total ASRM score (OR = 2.07, 95% CI 1.12-4.14; P = 0.025). Women with ICE resected during the surgical procedure for LRE did not have more adverse postoperative clinical outcomes than ICE-negative patients.Conclusion Ileocaecal endometriosis was significantly associated with greater LRE severity. In a complete surgical resection strategy, combining resection of ICE and LRE did not appear to increase postoperative rates of complications, morbidity or recurrence, nor did it seem to impair long-term clinical outcomes.Keywords Complete surgery, deep infiltrating endometriosis, disease severity, ileocaecal endometriosis, low rectal endometriosis.Tweetable abstract In women with low rectal endometriosis, 25% have an associated ileocaecal location that is a marker for severity.

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Anterior Focal Adenomyosis and Bladder Deep Infiltrating Endometriosis: Is There a Link?

Cited by 36 publications

References 26 publications

Epidemiology of Adenomyosis

Epidemiology of Adenomyosis

Uterine polyps, adenomyosis, leiomyomas, and endometrial receptivity

Associated ileocaecal location is a marker for greater severity of low rectal endometriosis

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