MSERM – Concomitant Endometriosis in Patients UNDERGOING Hysterectomy With Suspected Adenomyosis

Track: Endometriosis
Poster : Endometriosis
Adela G. Cope
Assistant Professor of Obstetrics and Gynecology
Mayo Clinic
Rochester, Minnesota

Objective: The current study aims to evaluate the prevalence of concomitant endometriosis in patients undergoing laparoscopic hysterectomy (LH) with suspected adenomyosis. Prior studies have estimated this rate to be 11-37.5%1-3 but have been limited by lack of laparoscopic pelvic assessment or clinical diagnosis of endometriosis without histologic confirmation. DESIGN: Retrospective case series at an academic medical center. MATERIALS AND

Methods: Premenopausal women who underwent LH and had suspected adenomyosis by imaging or confirmed by pathology between 10/1/2015-8/31/19 were included. Close peritoneal inspection was performed, and any visible lesions were excised to capture all cases of endometriosis. Descriptive statistics were performed.

Results: A total of 105 patients met inclusion criteria with a mean age of 42.8±5.8 years old. The most common indications for surgical intervention were dysmenorrhea or pelvic pain (n=89, 84.8%) and/or abnormal uterine bleeding (n=87, 82.9%). Of the 68 women with suspected adenomyosis on imaging, 39 were confirmed on pathology (57.3%). Peritoneal lesions were excised in 81 patients (77.1%), with positive pathology for endometriosis in 64 of 81 (79.0%). Concomitant endometriosis was identified in 69% of women with suspected adenomyosis based on preoperative imaging (47 of 68) and 56% of women with confirmed adenomyosis on pathology (42 of 75). In patients with dysmenorrhea or pelvic pain, the rate of concomitant endometriosis was 77.0% (47 of 61) in those with suspected adenomyosis on imaging.

Conclusions: Endometriosis was found in 77.0% of women with suspected adenomyosis and dysmenorrhea or pelvic pain, suggesting a role for careful examination of the pelvis at hysterectomy in this population. Further confirmation with a larger sample size and pain outcome data would assist with clinical decision making and counseling.

ASMR official sponsorship in the publications of the virtual ASMR conference October 17-21 October 2020