UTERINE AND VAGINAL MALFORMATIONS CONCURRENT WITH ENDOMETRIOSIS: MANAGEMENT TACTICS AND SURGICAL CORRECTION


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Objective. To optimize the results of surgical treatment and rehabilitation in patients with congenital uterine and vaginal malformations concurrent with external genital endometriosis. Subjects and methods. A total of 198 patients with uterine and vaginal abnormalities were operated on at the Department of Operative Gynecology, V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, in 2013 to 2015. According to the presence or absence of foci of external genital endometriosis, two groups were formed: 1) 105 patients with uterine and vaginal abnormalities and concurrent external genital endometriosis; 2) 93 patients with uterine and vaginal abnormalities without concurrent endometriosis. Results. The indicators for surgical treatment were primary infertility (41.5%), secondary infertility (18.6%), recurrent miscarriage (26.2%), dysmenorrhea (45.4%), menorrhagia (23.2%), pain syndrome (17.2%), and dyspareunia (8.1 %). The rate of external genital endometriosis was 53.0%. No significant differences were found in the rate of endometriosis between the patients with and without menstrual blood outflow. Conclusion. The implantation theory cannot explain all cases of endometriosis developed in patients with uterine and vaginal defects. Consequently, all pathogenetic mechanisms should be borne in mind when studying the possible ways how endometriosis develops in congenital anomalies of the female genitalia.

Full Text

Restricted Access

About the authors

Kristina N. Farkhat

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

PhD student Moscow 117997, Ac. Oparina str. 4, Russia

Leila V. Adamyan

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia; Moscow State University of Medicine and Dentistry

Academician of the (RAMS), MD, PhD, Professor, Honored Master of Science of the Russian Federation, Head Specialist in Obstetrics and Gynecology of Ministry of Health of Russia, Head of the Department of Surgical Gynecology; Head of the Department of Reproductive Medicine and Surgery, Faculty of Postgraduate Education Moscow 117997, Ac. Oparina str. 4, Russia

References

  1. Chan Y.Y., Jayaprakasan K., Zamora J., Thornton J.G., Raine-Fenning N., Coomarasamy A. The prevalence of congenital uterine anomalies in unselected and high-risk populations: a systematic review. Hum. Reprod. Update. 2011; 17(6): 761-71.
  2. Saravelos S.H., Cocksedge K.A., Li T.C. Prevalence and diagnosis of congenital uterine anomalies in women with reproductive failure: a critical appraisal. Hum. Reprod. Update. 2008; 14(5): 415-29.
  3. Acién P., Acién M. The presentation and management of complex female genital malformations. Hum. Reprod. Update. 2016; 22(1): 48-69.
  4. Uğur M., Turan C., Mungan T., Kuşçu E., Senöz S., Ağiş H.T. et al. Endometriosis in association with müllerian anomalies. Gynecol. Obstet. Invest. 1995; 40(4): 261-4.
  5. Signorile P.G., Baldi F., Bussani R., Viceconte R., Bulzomi P., D’Armiento M. et al. Embryologic origin of endometriosis: analysis of 101 human female fetuses. J. Cell. Physiol. 2012; 227(4): 1653-6.
  6. Heinonen P.K. Pregnancies in women with uterine malformation, treated obstruction of hemivagina and ipsilateral renal agenesis. Arch. Gynecol. Obstet. 2013; 287(5): 975-8.
  7. Адамян Л.В., Глыбина Т.М., Макиян З.Н., Степанян А.А., Гаджиева З.А., Панов В.О., Кулабухова Е.А. Цервиковагинальная аплазия: методы хирургической коррекции. Акушерство и гинекология. 2013; 2: 51-6.
  8. Gergolet M., Gianaroli L., Kenda Suster N., Verdenik I., Magli M.C., Gordts S. Possible role of endometriosis in the aetiology of spontaneous miscarriage in patients with septate uterus. Reprod. Biomed. Online. 2010; 21(4): 581-5.
  9. Nouri K., Ott J, Huber J.C., Fischer E.M., Stögbauer L., Tempfer C.B. Reproductive outcome after hysteroscopic septoplasty in patients with septate uterus--a retrospective cohort study and systematic review of the literature. Reprod. Biol. Endocrinol. 2010; 8: 52.
  10. Адамян Л.В., Кулаков В.И., Хашукоева А.З. Пороки развития матки и влагалища. М.: Медицина; 1998. 67с.
  11. Адамян Л.В., Богданова Е.А., Степанян А.А., Окулов А.Б., Глыбина Т.М., Макиян З.Н., Курило Л.Ф. Аномалии развития женских половых органов: вопросы идентификации и классификации (обзор литературы). Проблемы репродукции. 2010; 16(2): 7-15.
  12. The Revised American Society for Reproductive Medicine. Classification of endometriosis: 1996. Fertil. Steril. 1997; 67(5): 817-21.
  13. Cho M.K., Kim C.H., Oh S.T. Endometriosis in a patient with Rokitansky-Kuster-Hauser syndrome Moon. J. Obstet. Gynaecol. Res. 2009; 35(5): 994-6.
  14. Troncon J.K., Zani A.C., Vieira A.D., Poli-Neto O.B., Nogueira A.A., Rosa-E-Silva J.C. Endometriosis in a patient with Mayer-Rokitansky-Küster-Hauser syndrome. Case Rep. Obstet. Gynecol. 2014; 2014: 376231.
  15. Johnson N.P., Hummelshoj L.; World Endometriosis Society Montpellier Consortium. Consensus on current management of endometriosis. Hum. Reprod. 2013; 28(6): 1552-68.
  16. Адамян Л.В., Фархат К.Н., Макиян З.Н., Савилова А.М. Молекулярно-биологическая характеристика эутопического и эктопического эндометрия (обзор литературы). Проблемы репродукции. 2015; 21(5): 8-16

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies