Uterine adenomyosis in persistence of dysmenorrhea after surgical excision of pelvic endometriosis and colorectal resection

Simone Ferrero, Giovanni Camerini, Mario Valenzano Menada, Ennio Biscaldi, Nicola Ragni, Valentino Remorgida

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To determine whether the presence of uterine adenomyosis may impair the amelioration of pain symptoms after laparoscopic excision of pelvic endometriosis combined with colorectal resection. STUDY DESIGN: This prospective study included 50 women with bowel endometriosis with or without uterine adenomyosis. Presence of uterine adenomyosis was investigated by magnetic resonance imaging. Patients underwent excision of pelvic endometriosis and colorectal resection; some patients with focal adenomyosis underwent uterine surgery. Pain symptoms and gastrointestinal complains were evaluated before surgery and at 6, 12 and 18 months' follow-up. RESULTS: At 6-month follow-up, dysmenorrhea significantly improved in women without uterine adenomyosis and in those with adenomyosis that was excised at surgery; this improvement persisted at 18 months' follow-up. No significant improvement in dysmenorrhea was observed in women with adenomyosis not excised at surgery. Deep dyspareunia and chronic pelvic pain significantly improved at follow-up in all study groups. Most of gastrointestinal symptoms improved or disappeared at 6 months' follow-up; the improvement in gastrointestinal function persisted at 18 months' follow-up. CONCLUSION: Excision of pelvic endometriosis combined with bowel resection significantly improves chronic pelvic pain, dyspareunia and gastrointestinal symptoms; however, the presence of uterine adenomyosis may determine persistence of dysmenorrhea.

Original languageEnglish
Pages (from-to)366-372
Number of pages7
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume54
Issue number6
Publication statusPublished - Jun 2009

Keywords

  • Adenomyosis
  • Bowel endometriosis
  • Colorectal resection
  • Endometriosis
  • Laparoscopy

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Reproductive Medicine

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