Endometriomas and adenomyosis: two faces of the same process

• Lyudmila Yu. Karakhalis
• Olga A. Tomilina

Abstract

Background. Endometriomas and adenomyosis occur in women of reproductive age. There are some differences between these nosologies that relate to complaints, menstrual function, reproductive history, differences in coexistent somatic and gynecological morbidity, which justifies the need to compare these manifestations of genital endometriosis.

The aim of the study was to determine the main risk factors for the development of endometriomas and adenomyosis, to compare and assess their impact on the development of the pathological process.

Material and methods. A cohort observational study of medical documentation was carried out in 100 operated patients with endometriomas (group 1) and 85 patients with adenomyosis (group 2). Reproductive, somatic history was studied, risk factors in the both groups were assessed. The statistical analysis was carried out using the Statistica 13.3 program (USA, Tibco). The generally accepted level of statistical significance p=0.005 was used, at p<0.005 the difference in the obtained values was considered statistically significant.

Results. Endometriomas and adenomyosis have various complaints, risk factors, as well as characteristics of course of the disease. There was a significant difference between the groups in age, body mass index (BMI), age of onset of first menstruation, its duration and duration of the menstrual cycle. Patients with adenomyosis were more likely to have a history of caesarean section, and patients with endometriomas were more likely to have a history of premature birth. The development of pathological processes is affected by hereditary pathology, coexistent extragenital and gynecological diseases, which were more often identified in the group 2. A higher adherence to hormonal treatment was established in patients with adenomyosis (group 2).

Conclusion. Despite the common risk factors, there are also differences. Both groups have endocrinopathies and gastrointestinal diseases detected in patients, but in group 2 there were also anemia, allergies, genital inflammation and a higher incidence of infertility were also detected (in contrast to group 1). Also, patients with adenomyosis are more committed to the prescribed hormonal therapy. Group 1 was more characterized by a young reproductive age, significantly high BMI, a relatively high frequency of patients with bad habits and differences in the age of menarche, duration of menstruation and menstrual cycle.

Keywords: endometrioma; adenomyosis; risk factors; clinical picture

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