Department of Clinical and Experimental Biomedical Sciences, University of Florence, Florence, Italy.
Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy.
Gynecol Endocrinol. 2020 Sep;36(9):808-812. doi: 10.1080/09513590.2020.1736027. Epub 2020 Mar 5.
Endometriosis is a gynecological disease characterized by pain and infertility. The diagnosis is very often made during the infertility work-up, together with other reproductive diseases and uterine disorders. A retrospective cohort study was conducted on infertile women with clinical or ultrasound suspect of endometriosis, undergoing an ultrasound (US) evaluation by a team of expert sonographers ( = 419), with the aim to evaluate the prevalence of concomitant uterine disorders. The US coexistence of endometriosis with uterine fibroids and/or adenomyosis was investigated according to three age intervals (<35years; 35 ≥ years <45; ≥45 years) and to endometriosis phenotypes: ovarian endometriosis (OMA), deep infiltrating endometriosis (DIE), or both. The US diagnosis of fibroids was made in 3.1% of cases, adenomyosis was found in 21.2%, and the co-existence of both uterine disorders with endometriosis was reported in 14.6% of patients. When analyzed according to age, patients aged >35 years were more likely to be affected by uterine fibroids ( = .003), adenomyosis ( = .030) and both adenomyosis and fibroids ( < .0001). No statistically significant association was found between endometriosis phenotypes and myometrial pathologies. Uterine disorders coexistence should be considered in the assessment of women with endometriosis, in order to better define a treatment strategy for infertility, especially in women older than 35 years.
子宫内膜异位症是一种以疼痛和不孕为特征的妇科疾病。诊断通常在不孕检查过程中与其他生殖疾病和子宫异常一起进行。对患有临床或超声怀疑子宫内膜异位症的不孕妇女进行了回顾性队列研究，由一组专家超声医师（ = 419）进行超声（US）评估，目的是评估同时存在的子宫疾病的患病率。根据三个年龄间隔（<35 岁；35 岁≥ <45 岁；≥45 岁）和子宫内膜异位症表型（卵巢子宫内膜异位症 [OMA]、深部浸润性子宫内膜异位症 [DIE]或两者兼有），研究了 US 子宫内膜异位症与子宫肌瘤和/或腺肌病共存的情况。US 诊断出 3.1%的病例有肌瘤，21.2%的病例有腺肌病，14.6%的患者同时存在两种子宫疾病和子宫内膜异位症。根据年龄分析，年龄>35 岁的患者更有可能患子宫肌瘤（ = .003）、腺肌病（ = .030）和子宫肌瘤和腺肌病两者都有（ < .0001）。子宫内膜异位症表型与子宫肌层病变之间没有统计学上的显著关联。在评估子宫内膜异位症患者时，应考虑子宫疾病的共存，以便更好地确定不孕的治疗策略，尤其是在年龄>35 岁的女性中。
