Adenomyosis Increases Risk of Surgical Complications

Adenomyosis increases the risk of complications in women undergoing laparoscopic surgery to treat deep endometriosis.

Key Points

Highlights: 

• Adenomyosis increases the risk of surgical complications for deep endometriosis.

Importance:

• Patients with adenomyosis who will undergo surgery to treat deep endometriosis should be informed about this risk.

What's done here:

• A retrospective cohort study assessed the effect of adenomyosis on surgical complications in 157 women with deep endometriosis. 

Key results:

• One-third (33.76%) of women who had adenomyosis had surgical complications.
• Only around one-tenth (12.5%) of women without adenomyosis had surgical complications.
• Women with adenomyosis had a 4.56-fold increased risk of having surgical complications.

Limitations:

• This was a retrospective, single-center study and the absence of previous studies meant no power calculation could be made to determine the sample size.
• There may be a patient selection bias since women who were referred to the Endometriosis Unit of a tertiary university center and therefore likely had a more complex disease were included and may not represent the general endometriosis population.
• Patients were staged according to the revised American Society for Reproductive Medicine (rASRM) classification score, which does not reflect surgical complexity.

Lay Summary

Adenomyosis increases the risk of deep endometriosis surgery complications, according to a new study published in the journal Scientific Reports.

Patients with deep endometriosis and adenomyosis should therefore be informed about this risk before undergoing surgery.

Adenomyosis occurs together with deep endometriosis in up to half of the cases. But it is not known how the presence of adenomyosis affects the outcome of deep endometriosis surgery and any surgical complications. 

Here, a team of researchers from Spain led by Dr. Francisco Carmona conducted a retrospective cohort study on 157 women with deep endometriosis to assess the effect of adenomyosis on surgical complications. Based on transvaginal ultrasound, almost half of the women (49%) had adenomyosis. 

The researchers found that 33.76% of women who had adenomyosis had surgical complications. This percentage was much lower with 12.5% for women who did not have adenomyosis. 

Statistical analysis showed that women with adenomyosis had almost a 5 fold higher risk of developing surgical complications compared to women without adenomyosis. This was independent of undergoing a hysterectomy. “There was a statistically significant association between the number of criteria of adenomyosis present in each patient and the proportion of patients presenting surgical complications,” the researchers noted.

More research is now needed to confirm these findings and better analyze the effect of different types of adenomyosis and severities of deep endometriosis.

Research Source: https://pubmed.ncbi.nlm.nih.gov/35490172/