Diseases that Coexist with Adenomyosis and Endometriosis

There are numerous gynecological and non-gynecological diseases that have been found to exhibit comorbidity with endometriosis and adenomyosis.

Key Points

Highlights:

• This study concentrates on two similar conditions: endometriosis and adenomyosis, characterized by endometrial glands and stroma found in a different location from the uterine cavity.
• The authors of the seek to identify gynecological and non-gynecological diseases that coexist with adenomyosis and endometriosis in Korean women.

Importance:

• This study may help elucidate the molecular mechanisms that link endometriosis and adenomyosis with the comorbidities.

What’s done here?

• The researchers searched through 3 years of Health Insurance Review and Assessment data for cases of endometriosis and adenomyosis. They were then able to calculate the yearly incidence of endometriosis and adenomyosis.
  • An accurate determination of endometriosis and adenomyosis was made using the participant’s management history.
  • To make a diagnosis, the researchers included women that had undergone gynecological ultrasonography.
• The researchers also looked for gynecological and non-gynecological diseases that could be comorbidities with endometriosis and adenomyosis.
  • Comorbidity was determined by the Fisher’s exact test, to ascertain if two diseases occurred independently of one another.
  • The Fisher's P-value summation method was used to determine the similarities between each of the three years. It was also used to combine the data of 3 years into one conclusive result.

Key results:

• There were a total of 61,516 participants in this study. The prevalence of endometriosis and adenomyosis was relatively similar each year.
  • In 2009, 12.4% of the participants had adenomyosis, and 9.3% had endometriosis.
  • In 2010, 12.5 % of the participants had adenomyosis, and 9.4% had endometriosis.
  • In 2011, 13.3 % of the participants had adenomyosis, and 9.1% had endometriosis.
• There were 31 International Classification of Disease, 10th revision (ICD-10) codes, namely other diseases, with significant relation to adenomyosis.
• There were 44 ICD-10 codes with significant relation to endometriosis.
• Gynecological diseases linked to endometriosis and adenomyosis include:
  • Leiomyoma
  • Benign ovarian tumor
• Non-gynecological illnesses related to endometriosis and adenomyosis include:
  • Anemia
  • Hypercholesterolemia
• The results of this study prove that health care providers should take care to monitor for gynecological and non-gynecological diseases with comorbidities in patients with endometriosis or adenomyosis.

Limitations of the study:

• One of the limitations is the diagnoses were clinical and not pathological, which could have led to the omission or incorrect classification of the disease.
• Another limitation is the fact that the data came from a variety of institutions, which could adversely impact the integrity of the data.
• The participants were all from one country. Thus the results of the study may not be applicable at a global level.

Lay Summary

Adenomyosis, defined by endometrial glands and stroma found within the muscular uterine wall, and endometriosis are two common gynecological diseases that are similar pathologically and symptomatically. Choi et al. recently conducted a study where they hoped to determine the prevalence of these two diseases. That being said, the main focus of the study was to identify gynecological and non-gynecological diseases that exhibit comorbidity with endometriosis and adenomyosis. Their experimental process and results can be found in an article titled “Comorbidity of gynecological and non-gynecological diseases with adenomyosis and endometriosis” that was recently published in Obstetrics & Gynecology Science.

The experimental process consisted of the researchers consulting 3 years of Health Insurance Review and Assessment data for cases of endometriosis and adenomyosis. The researchers could then determine the yearly incidence of both diseases. Next, the researchers looked for gynecological as well as non-gynecological diseases that could be considered comorbidities with endometriosis and adenomyosis. A Fisher’s exact test was used to discern a connection between diseases. A Fisher’s P-value summation method was utilized to identify the similarities between the data from the 3 years. It was also used to amalgamate 3 years of results.

There were 61,516 participants in this study. After looking at the data from all these participants, the researchers came to the conclusion that the prevalence rates of endometriosis and adenomyosis were comparable in 2009, 2010, and 2011. The researchers also found 31 International Classification of Disease, 10th revision (ICD-10) codes, or significant comorbidities, with adenomyosis and 44 ICD-10 codes with endometriosis. The gynecological diseases linked with adenomyosis and endometriosis include leiomyoma and benign ovarian tumor. The non-gynecological diseases linked with adenomyosis and endometriosis include anemia and hypercholesterolemia. In short, this study proves that health care providers must pay special attention to diseases with co-morbidities when observing a patient with adenomyosis or endometriosis. In doing so, the medical professional will be able to provide the patient with the most effective form of treatment and care.

Research Source: https://www.ncbi.nlm.nih.gov/pubmed/29184867