LONG-TERM RESULTS AFTER LAPAROSCOPIC INTERVENTIONS IN PATIENTS WITH CONCOMITANT ENDOMETRIOSIS AND ADENOMYOSIS
Keywords:laparoscopic intervention, endometriosis, adenomyosis, complications
The aim of the study was to evaluate postoperative outcomes in patients with endometriosis and adenomyosis. The study involved 109 women who had laparoscopic surgery 5 years ago for: chronic pelvic pain – in 29.4%, cystectomy – in 26.6%, hysterectomy – in 22.9%, myomectomy – in 21.1% patients. Stage I endometriosis was observed in 27.5%, stage II – in 26.6%, stage III – in 25.7%, stage IV – in 20.2% of patients. Concomitant adenomyosis occurs in patients with 3rd and 4th degree of severity of endometriosis. The patients were divided into 2 groups: group I - 59 patients with endometriosis without adenomyosis; group II - 50 patients with endometriosis and adenomyosis. There were no significant differences in average age, body mass index, parity and cases of pelvic pain between the groups. In group II patients, on average, the score on the VAS scale is significantly higher (p=0.045). In group II, dysmenorrhea was higher by 27.1% (p=0.038), dyspareunia – by 48.3% (p=0.042). The chance of developing dysmenorrhea among patients with endometriosis and adenomyosis is 2.3 times higher (OR=0.431, 95% CI 0.193-0.906, p<0.05); dyspareunia is 2.5 times higher (OR=0.407, 95%CI 0.170-0.976, p<0.05). The chance of meeting a woman with pelvic pain is 2.3 times higher among women with endometriosis and adenomyosis (OR=0.426, 95% CI 0.153-1.184, p>0.05). Out of 109 patients, 44.0% of women became pregnant, of which 19.3% had live children. In group II, the number of pregnancies was lower (χ2=3.776, p=0.052). Thus, in the long-term period after laparoscopic intervention, the probability of developing dysmenorrhea, dyspareunia, pelvic pain is high in women with endometriosis and adenomyosis, and the frequency of pregnancy was lower. We consider it appropriate to find such patients under close supervision after surgery.
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