Coincidence of uterine malformations and endometriosis: a clinically relevant problem?

Arch Gynecol Obstet. 2020 Nov;302(5):1237-1241. doi: 10.1007/s00404-020-05750-9. Epub 2020 Aug 20.


Introduction: It is suspected that uterine malformations and endometriosis have a high coincidence. Furthermore, it is expected that obstructive uterine malformations are significantly higher affected than non-obstructive malformations. The correlation between endometriosis and uterine malformations may be due to increased retrograde menstruation, which would explain a higher coincidence of obstructive malformations and endometriosis [14].

Methods: This retrospective study investigates whether patients with uterine malformations have a higher prevalence of endometriosis. The study includes patients with uterine malformations who were admitted to our hospital in the period from 01.12.2014 to 30.11.2019.

Results: 279 cases were analysed. 263 (94.2%) patients had a non-obstructive uterine malformation, 12 (4.3%) patients had an obstructive uterine malformation and 4 (1.4%) patients had uterine agenesia/hypoplasia. 209 (74.9%) patients had histologically confirmed endometriosis (peritoneal, ovarian or deep infiltrating) and 70 (25.1%) had no endometriosis. In 27 cases, deep infiltrating endometriosis (ENZIAN ABC) was detected additionally to peritoneal and ovarian endometriosis.

Conclusion: The study shows a high prevalence of endometriosis in women with uterine malformations. For this reason, endometriosis should always be specifically sought in uterine malformations.

Keywords: Bicornuate uterus; Endometriosis; Septate uterus; Unicornuate uterus; Uterus malformations.

MeSH terms

  • Adult
  • Endometriosis / complications
  • Endometriosis / epidemiology*
  • Female
  • Humans
  • Infertility, Female / epidemiology
  • Infertility, Female / etiology*
  • Prevalence
  • Retrospective Studies
  • Urogenital Abnormalities / complications*
  • Urogenital Abnormalities / epidemiology
  • Uterus / abnormalities*

Supplementary concepts

  • Uterine Anomalies