Anterior Focal Adenomyosis and Bladder Deep Infiltrating Endometriosis: Is There a Link?

摘要

Study ObjectiveTo evaluate the association between bladder deep infiltrating endometriosis (DIE) and anterior focal adenomyosis of the outer myometrium (aFAOM) diagnosed by preoperative magnetic resonance imaging (MRI). DesignAn observational, cross-sectional study using prospectively collected data (Canadian Task Force classification II-2). SettingSingle university tertiary referral center. PatientsAll nonpregnant women younger than 42 years who had undergone complete surgical exeresis of endometriotic lesions. For each patient a standardized questionnaire was completed during a face-to-face interview conducted by the surgeon during the month preceding the surgery. Only women with preoperative standardized uterine MRI were retained for this study. InterventionsThirty-nine women with histologically proven bladder DIE and an available preoperative MRI were enrolled in the study. Patients were divided into 2 groups: women with aFAOM (aFAOM (+), n?=?19) and women without aFAOM (aFAOM (–), n?=?20). Both groups were compared for general characteristics, medical history, MRI findings, and disease severity. Measurements and Main ResultsNineteen patients (48.7%) with bladder DIE had aFAOM at preoperative MRI. The rate of associated diffuse adenomyosis was similar in the 2 groups (63.2% [n?=?12] vs 73.7% [n?=?14]; p?=?.48). The rate of an associated ovarian endometrioma (OMA) was significantly lower in the aFAOM (+) group (10.5% [n?=?2] vs 40.0% [n?=?8]; p?=?.03). There were fewer associated intestinal DIE lesions in the aFAOM (+) group compared with the aFAOM (–) group (26.3% vs 75.0%; p?=?.02), with lower involvement of the pouch of Douglas (26.3% vs 70%; p?