Clinic for Obstetrics and Gynecology, UKSH Campus Kiel, Kiel, Germany.
Clinic for Obstetrics and Gynecology, UKSH Campus Kiel, Kiel, Germany -
Minerva Med. 2020 Feb;111(1):33-49. doi: 10.23736/S0026-4806.19.06341-9. Epub 2019 Nov 12.
Endometriosis is a common disease in women of reproductive age. In addition to causing pain, it may also reduce fertility. The coexistence of endometriosis and congenital uterine anomalies (CUA) has been frequently reported in the published literature. The present report is a review of existing studies on the subject and our own hitherto unpublished data.
The electronic search was conducted using the Pubmed database with specific keyword combinations including endometriosis, adenomyosis, infertility, Müllerian malformations/anomalies, and septate uterus. The principal aspects addressed in the present study were: diagnosis, management, and classification of CUA, their impact on fertility and coexistence with endometriosis.
Endometriosis and CUA are frequently detected in the exploration of infertility, because both of these are liable to impair fertility. Endometriosis is associated with obstructive anomalies and nonobstructive malformations, especially those concerning the septate uterus. The diagnosis and management of CUA have been discussed for several years. Various classification systems have been proposed.
The analysis of the existing literature has revealed the absence of any consensus about the management, diagnosis, and classification of CUA, especially with regard to the septate uterus. We need to find and speak a common language in order to avoid inappropriate or unnecessary surgery and optimize the individual patient's treatment. The combined presence of endometriosis or adenomyosis and CUA is a reason to perform precise diagnostic imaging investigations and early surgery for the purpose of enhancing the chances of pregnancy in infertile patients. Further research is needed on the subject.
子宫内膜异位症是育龄妇女的常见病。除引起疼痛外，还可能降低生育能力。子宫内膜异位症和先天性子宫畸形（CUA）并存已在已发表的文献中频繁报道。本报告是对现有研究的综述，以及我们迄今为止未发表的数据。
使用 Pubmed 数据库进行电子检索，使用特定的关键词组合，包括子宫内膜异位症、子宫腺肌病、不孕、米勒管畸形/异常和纵隔子宫。本研究主要涉及以下方面：CUA 的诊断、管理和分类，它们对生育的影响以及与子宫内膜异位症的共存。
在不孕不育的探索中，经常会发现子宫内膜异位症和 CUA，因为两者都可能损害生育能力。子宫内膜异位症与阻塞性异常和非阻塞性畸形有关，尤其是纵隔子宫。CUA 的诊断和管理已经讨论了多年。已经提出了各种分类系统。
对现有文献的分析表明，对于 CUA 的管理、诊断和分类，特别是对于纵隔子宫，没有任何共识。我们需要找到并使用共同的语言，以避免不必要或不适当的手术，并优化患者的个体治疗。子宫内膜异位症或子宫腺肌病和 CUA 的并存是对不孕患者进行精确诊断性影像学检查和早期手术以提高妊娠机会的原因。需要对此主题进行进一步研究。
