Endometriosis was detected in The results suggest that symptomatic endometriosis appears together with symptomatic uterine fibroids. Both diseases seem to decrease female fertility independently of each other. Common symptoms are menorrhagia, pelvic pressure or pain and urinary symptoms. The proportion of asymptomatic women is significant. It has been suggested that these two disorders may be associated with each other and that their etiology has some similarities.
In addition, if the connection seems to be apparent, we wanted to evaluate whether they both affect female fertility independently of each other.
We retrospectively studied the hospital records of patients operated on for endometriosis or uterine fibroids the study groups or sterilization the control group between the years and at the Department of Obstetrics and Gynecology, Oulu University Hospital. The search was made for the hospital records based on the diagnosis numbers for endometriosis, uterine fibroids and birth control planning, and on the operation numbers for explorative laparoscopy, laparoscopic excision of peritoneum lesion, abdominal and laparoscopical hysterectomy and sterilization.
The subjects undergoing sterilization had no symptoms of endometriosis or uterine fibroids. Only subjects with complete hospital records were included. The diagnosis of endometriosis was based on the pelvic view during laparoscopic sterilization. The diagnosis of fibroids was based on a preoperative transvaginal ultrasonographic examination. Subjects aged 35 years or older at the time of operation were included. This age limit was chosen because endometriosis has its highest incidence during the early fertile years and it tends to disappear after ovarian function declines.
The association of the diseases was analyzed as follows: The presence of endometriosis, uterine fibroids, or both occurring together was analyzed in all groups. Then an analysis was made among different age groups in the fibroid group and the control group comparison 1 and between the endometriosis group and the control group comparison 2.
The endometriosis group comprised patients, the uterine fibroid group patients, and the control group patients [ Table 1 , Figure 1 ]. Since 47 patients had both conditions they were included in both disease groups. The comparisons are made within the disease group and the control group, so this does not disturb the analysis. Departure from a normal distribution was assessed using the Kolmogorov-Smirnov test.
Paired t-tests were used for normally distributed data, and the Mann-Whitney test the signed-rank for skewed data. The patients were divided into subgroups according to their age. The age-groups were patients age , and 45 years and older [ Table 2 ].
A logistic regression analysis was used to identify independent factors affecting parity, which here reflects fertility status. Parity was assessed as either having no deliveries or having at least one delivery. Only statistically significant factors were included in the final model.
The Hosmer-Lemeshow goodness-of-fit statistic was used to assess the final model. The factors selected for the final analysis were diagnosis of endometriosis and diagnosis of uterine fibroids at the time of operation. All factors were treated as dichotomous variables: Existence of endometriosis or no endometriosis; existence of fibroids or no fibroids.
In the fibroid group, The mean difference of the prevalence between the groups was The comparison in different age groups revealed that the prevalence of endometriosis was increased among fibroid patients compared to the control group in the age groups and After age 45 the prevalence of endometriosis decreased remarkably in the fibroid group, from There were fewer deliveries in the fibroid group than in the control group [ Table 3 ].
Patients with fibroids had a slightly higher BMI than the patients in the control group, In the endometriosis group, The mean difference of the prevalence between the endometriosis and control groups was The difference in the prevalence of uterine fibroids in the endometriosis and control group remained stable with advanced female age.
The prevalence of uterine fibroids in the endometriosis group increased significantly with advancing age, from There were fewer deliveries in the endometriosis group than in the control group [ Table 3 ]. There was not a statistically significant difference in BMI between these groups. In the disease groups, there were altogether 47 patients with both conditions. There were no such cases in the control group.
Since the prevalence of endometriosis and fibroids seemed to coincide, we wanted to test whether they both are independent factors associated with subfertility. We used logistic regression analysis, in which nulliparity at the time of operation was determined as subfertility [ Table 4 ]. Data fitted the logistic regression analysis, as indicated by the Hosmer—Lemeshow goodness-of-fit test. Both endometriosis and fibroids proved to be independent factors associated with nulliparity.
Association for nulliparity. Logistic regression analysis revealed two independent factors, uterine fibroids and endometriosis that were significantly associated with nulliparity. As fibroids grow larger, depending on their size and location, they may cause pain by putting pressure on organs.
In addition, they could cause swelling that is often mistaken as weight gain or pregnancy. Even small fibroids can cause pressure, depending on their location. But this symptom could also indicate adenomyosis or endometriosis.
So you should see your doctor at the first sign of pressure or pain in your pelvis. Fibroids can press against the bladder causing frequent urination and even loss of bladder control. Not only can this cause a great deal of pain, it can disrupt your everyday activities.
In addition, fibroid growth can place pressure on the bowel, causing constipation and bloating. If you are experiencing any of the symptoms listed above, or these additional fibroid symptoms, schedule an immediate appointment with our fibroid specialists.
Fibroids can usually be found during a simple abdominal or pelvic exam. If your doctor feels that you may have fibroids, an ultrasound or MRI may be used to confirm the diagnosis and proceed with treatment. And, if your provider rules out fibroids as the cause of your symptoms, he or she may recommend further testing to confirm or rule out an endometriosis diagnosis. Study Results Blog.
Our Blog. Home Our Blog Uterine Fibroids vs. They grow inside the uterus, outside the uterus, and in the wall lining of the uterus. Endometriosis- Endometrial tissue like the lining of the uterus grows outside of the uterus where the body is not able to get rid of it as it does in a normal menstrual cycle. It attaches itself to organs, not in the uterus such as fallopian tubes, bladder, large intestine, and even the lungs. This tissue builds up over time as scar tissue forms around them, causing various levels of pain and discomfort.
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