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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research Malahayati International Journal of Nursing and Health Science
Ninda Frymonalitza
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Impact of Co-existing Adenomyosis on Pain Recurrence Following Deep Endometriosis Excision: A Systematic Review and Meta-Analysis of Multivariate-Adjusted Observational Cohorts Ninda Frymonalitza
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1509

Abstract

Background: Deep endometriosis (DE) represents a severe phenotype characterized by subperitoneal infiltration >5mm. While complete surgical excision is the gold standard, postoperative recurrence of pain and lesions remains clinically significant. Growing evidence implicates co-existing adenomyosis as a prognostic factor, yet its independent impact on DE surgery outcomes is debated. Methods: We conducted a systematic review and meta-analysis of observational studies published between 2014 and 2025. Data were synthesized from seven high-quality studies involving 2,056 participants, focusing on those utilizing multivariate regression or propensity score matching. The primary outcomes were recurrence of pain (dysmenorrhea, dyspareunia), anatomical lesion recurrence, and surgical complications. Secondary outcomes included fertility. Results: The prevalence of adenomyosis in DE patients ranged from 35.6% to 49.05%. Patients with adenomyosis had significantly higher preoperative pain scores. Postoperatively, adenomyosis was an independent predictor of pain persistence and lesion recurrence. Extrinsic adenomyosis was associated with a 2.5-fold increased risk of early recurrence (OR 2.5; 95% CI 1.2–3.4). Survival analysis showed a 60% recurrence-free probability at 5 years for those with adenomyosis vs. 81% for those without. Surgical complications were significantly higher in the adenomyosis group (OR 4.56; 95% CI 1.90–11.30). Conclusion: Co-existing adenomyosis is a robust independent risk factor for failure of DE surgery, leading to persistent pain, lesion recurrence, and increased surgical morbidity. This supports the outside-in theory of pathogenesis. Preoperative screening for adenomyosis via TVS/MRI is mandatory for accurate counseling and surgical planning.
Impact of Co-existing Adenomyosis on Pain Recurrence Following Deep Endometriosis Excision: A Systematic Review and Meta-Analysis of Multivariate-Adjusted Observational Cohorts Ninda Frymonalitza
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i2.1509

Abstract

Background: Deep endometriosis (DE) represents a severe phenotype characterized by subperitoneal infiltration >5mm. While complete surgical excision is the gold standard, postoperative recurrence of pain and lesions remains clinically significant. Growing evidence implicates co-existing adenomyosis as a prognostic factor, yet its independent impact on DE surgery outcomes is debated. Methods: We conducted a systematic review and meta-analysis of observational studies published between 2014 and 2025. Data were synthesized from seven high-quality studies involving 2,056 participants, focusing on those utilizing multivariate regression or propensity score matching. The primary outcomes were recurrence of pain (dysmenorrhea, dyspareunia), anatomical lesion recurrence, and surgical complications. Secondary outcomes included fertility. Results: The prevalence of adenomyosis in DE patients ranged from 35.6% to 49.05%. Patients with adenomyosis had significantly higher preoperative pain scores. Postoperatively, adenomyosis was an independent predictor of pain persistence and lesion recurrence. Extrinsic adenomyosis was associated with a 2.5-fold increased risk of early recurrence (OR 2.5; 95% CI 1.2–3.4). Survival analysis showed a 60% recurrence-free probability at 5 years for those with adenomyosis vs. 81% for those without. Surgical complications were significantly higher in the adenomyosis group (OR 4.56; 95% CI 1.90–11.30). Conclusion: Co-existing adenomyosis is a robust independent risk factor for failure of DE surgery, leading to persistent pain, lesion recurrence, and increased surgical morbidity. This supports the outside-in theory of pathogenesis. Preoperative screening for adenomyosis via TVS/MRI is mandatory for accurate counseling and surgical planning.
Early gestational diagnosis of alobar holoprosencephaly with omphalocele: A case report Ninda Frymonalitza; Febriani
Malahayati International Journal of Nursing and Health Science Vol. 8 No. 9 (2025): Volume 8 Number 9
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/minh.v8i9.1241

Abstract

Background: Holoprosencephaly (HPE) is the most frequent congenital brain malformation, with alobar HPE representing the most severe form. It is often accompanied by other structural anomalies such as omphalocele, significantly complicating fetal prognosis and perinatal management. Purpose: To present the early gestational diagnosis of alobar holoprosencephaly with omphalocele. Method: A descriptive case report of a 40-year-old gravida 2 para 1 woman whose fetus was diagnosed via ultrasound at 17–18 weeks' gestation with alobar HPE and omphalocele. The case was managed through routine antenatal care and serial ultrasound monitoring. Results: Serial imaging revealed progressive ventriculomegaly and worsening abdominal wall defect. Despite the fatal nature of the anomalies, legal constraints in Indonesia prevented pregnancy termination. The fetus survived until intrauterine demise at 37–38 weeks, after which labor was induced and a stillborn delivered vaginally. Conclusion: This case underscores the importance of early gestational diagnosis and highlights the ethical and legal challenges in managing lethal fetal anomalies in restrictive settings. Comprehensive parental counseling and genetic evaluation are crucial components in delivering informed care.
Co-Authors Febriani