Do symptomatic endometriosis and uterine fibroids appear together?

Uimari, Outi; Järvelä, Ilkka Y.

doi:10.4103/0974-1208.82358

Cited by 45 publications

(35 citation statements)

References 24 publications

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“…Adenomyosis and endometriosis were the most common secondary diagnoses, and endocavitary location was the most common fibroid‐related feature revealed by MRI. Our results were consistent with the previously published rates of co‐conditions in patients with symptomatic uterine fibroids, specifically adenomyosis (36–50%) and endometriosis (12–20%) …”

Section: Discussionsupporting

confidence: 93%

“…Our results were consistent with the previously published rates of co-conditions in patients with symptomatic uterine fibroids, specifically adenomyosis (36-50%) and endometriosis (12-20%). 19,[25][26][27] Although MRI offers better characterization of fibroid features and detection of coexisting gynecologic conditions, the routine use of pelvic MRI may not be feasible in clinical practices with restricted resources and limited availability of MRI. Our study revealed that pelvic pain, a QoL score below 30 out of 100, and multiple fibroids visualized on US are associated with the presence of additional information on MRI.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the routine use of pelvic MRI in women presenting with symptomatic uterine fibroids: When is pelvic MRI useful?

Fast

Shaffer

et al. 2019

Magnetic Resonance Imaging

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Background Pelvic ultrasound (US) diagnosis of uterine fibroids may overlook coexisting gynecological conditions that contribute to women's symptoms. Purpose To determine the added value of pelvic MRI for women diagnosed with symptomatic fibroids by US, and to identify clinical factors associated with additional MRI findings. Study Type Retrospective observational study. Population In all, 367 consecutive women with fibroids diagnosed by US and referred to our multidisciplinary fibroid center between 2013–2017. Field Strength/Sequence All patients had both pelvic US and MRI prior to their consultations. MRIs were performed at 1.5 T or 3 T and included multiplanar T2‐weighted sequences, and precontrast and postcontrast T1‐weighted imaging. Assessment Demographics, symptoms, uterine fibroid symptom severity scores, and health‐related quality of life scores, as well as imaging findings were evaluated. Statistical Tests Patients were separated into two subgroups according to whether MRI provided additional findings to the initial US. Univariate and multivariate regression analyses were performed. Results Pelvic MRI provided additional information in 162 patients (44%; 95% confidence interval [CI] 39–49%). The most common significant findings were adenomyosis (22%), endometriosis (17%), and partially endocavitary fibroids (15%). Women with pelvic pain, health‐related quality of life scores less than 30 out of 100, or multiple fibroids visualized on US had greater odds of additional MRI findings (odds ratio [OR] 1.68, 2.26, 1.63; P = 0.02, 0.004, 0.03, respectively), while nulliparous women had reduced odds (OR 0.55, P = 0.01). Patients with additional MRI findings were treated less often with uterine fibroid embolization (14% vs. 36%, P < 0.001) or MR‐guided focused US (1% vs. 5%, P = 0.04), and more often with medical management (17% vs. 8%, P = 0.01). Data Conclusion Pelvic MRI revealed additional findings in more than 40% of women presenting with symptoms initially ascribed to fibroids by US. Further evaluation using MRI is particularly useful for parous women with pelvic pain, poor quality of life scores, and/or multiple fibroids. Level of Evidence: 4 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Evaluation of the routine use of pelvic MRI in women presenting with symptomatic uterine fibroids: When is pelvic MRI useful?

Fast

Shaffer

et al. 2019

Magnetic Resonance Imaging

View full text Add to dashboard Cite

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“…In lung tissue, cytochrome P450 enzymes may be affected by air pollutants, and the CYP2C19*2 genotype has been implicated as a risk factor for asthma[47]. Also, linkage analysis on families with endometriosis, a disorder that may be correlated with uterine fibroids[45], indicates a potential role of CYP2C19 in endometriosis risk[39]. Association results with CYP2C19 present exciting connections that warrant further exploration.…”

Section: Discussionmentioning

confidence: 99%

Knowledge Driven Binning and Phewas Analysis in Marshfield Personalized Medicine Research Project Using Biobin

Basile

Wallace

Peissig³

et al. 2015

Biocomputing 2016

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Next-generation sequencing technology has presented an opportunity for rare variant discovery and association of these variants with disease. To address the challenges of rare variant analysis, multiple statistical methods have been developed for combining rare variants to increase statistical power for detecting associations. BioBin is an automated tool that expands on collapsing/binning methods by performing multi-level variant aggregation with a flexible, biologically informed binning strategy using an internal biorepository, the Library of Knowledge (LOKI). The databases within LOKI provide variant details, regional annotations and pathway interactions which can be used to generate bins of biologically-related variants, thereby increasing the power of any subsequent statistical test. In this study, we expand the framework of BioBin to incorporate statistical tests, including a dispersion-based test, SKAT, thereby providing the option of performing a unified collapsing and statistical rare variant analysis in one tool. Extensive simulation studies performed on gene-coding regions showed a Bin-KAT analysis to have greater power than BioBin-regression in all simulated conditions, including variants influencing the phenotype in the same direction, a scenario where burden tests often retain greater power. The use of Madsen-Browning variant weighting increased power in the burden analysis to that equitable with Bin-KAT; but overall Bin-KAT retained equivalent or higher power under all conditions. Bin-KAT was applied to a study of 82 pharmacogenes sequenced in the Marshfield Personalized Medicine Research Project (PMRP). We looked for association of these genes with 9 different phenotypes extracted from the electronic health record. This study demonstrates that Bin-KAT is a powerful tool for the identification of genes harboring low frequency variants for complex phenotypes.

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“…Endometriosis, adenomyosis and leiomyomata develop in women of reproductive age and regress after menopause or removal of ovaries, indicating that they grow in an estrogen-dependent manner. These diseases appear to have some common pathogenetic pathways [8]. A recent study suggested that the PVUII polymorphism of the ERalpha gene is associated with the risk for endometriosis, adenomyosis, and leiomyomata [9].…”

Section: Commentarymentioning

confidence: 99%

Intra-ligamentous fibroid removed laparoscopically

Heaton¹,

Walid²

2011

OJOG

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In this paper, we report the case of a left round ligament fibroid in a 24 year-old, gravida 0, female that was successfully managed laparoscopically. Operative findings also included severe adnexal adhesions bilaterally, severe adhesions of the liver to the anterior abdominal wall (Fitz-Hugh-Curtis syndrome), pigmented areas on the left tube, uterus and posterior broad ligament (that proved to be endometriosis), and low capacity bladder (450 cc at 70 cm water pressure) with florid glomerulations and Hunner's ulcers consistent with typical interstitial cystitis. Beside the feasibility of laparoscopic management of intra-ligamentous tumors this case highlights the common multifactorial nature of chronic pelvic pain and the frequent association of endometriosis and interstitial cystitis.

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Do symptomatic endometriosis and uterine fibroids appear together?

Cited by 45 publications

References 24 publications

Evaluation of the routine use of pelvic MRI in women presenting with symptomatic uterine fibroids: When is pelvic MRI useful?

Evaluation of the routine use of pelvic MRI in women presenting with symptomatic uterine fibroids: When is pelvic MRI useful?

Knowledge Driven Binning and Phewas Analysis in Marshfield Personalized Medicine Research Project Using Biobin

Intra-ligamentous fibroid removed laparoscopically

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