Determinants of adenomyosis in women who underwent hysterectomy for benign gynecological conditions: Results from a prospective multicentric study in Italy

Parazzini, Fabio; Mais, Valerio; Cipriani, Sonia; Busacca, Mauro; Venturini, P. L.

doi:10.1016/j.ejogrb.2008.12.010

Cited by 104 publications

(103 citation statements)

References 11 publications

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“…Parazzini F, et al also reported that women with adenomyosis had more dysmenorrhoea and chronic pelvic pain but not dyspareunia. 17 Symptoms of heavy /abnormal bleeding are thought to be positively associated with the depth of penetration of adenomyosis into myometrium.…”

Section: Discussionmentioning

confidence: 99%

Adenomyosis at Hysterectomy: Prevalence, Patient Characteristics, Clinical Profile and Histopatholgical Findings

Shrestha

Sedhai

et al. 2012

Kathmandu Univ. Med. J.

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BackgroundUnderlying adenomyosis is often the cause of treatment failure for patients undergoing medical therapy for abnormal uterine bleeding and or chronic pelvic pain. Given the limitation of ultrasonography in diagnosing adenomyosis and MRI being unaffordable to most of the patients belonging to developing countries like us, it often remains undiagnosed before a hysterectomy. ObjectiveTo find out the clinical profile associated with adenomyosis and to determine the prevalence of adenomyosis in hysterectomy specimens; frequency distribution, as well as to correlate clinical examination with histopathological examination. MethodsA total of 60 women who had undergone hysterectomy with histopathologically proven adenomyosis between April 2009 and March 2010 were included . Data were collected on indication for the intervention, age, symptoms, clinical findings, hemoglobin, menopausal status, gross and histopathological findings. ResultsA total of 256 women were scheduled for hysterectomy. Adenomyosis was diagnosed in 60 of 256 cases (23.4%). Menorrhagia (91.2%), dysmenorrhoea (84.2%), lower abdominal pain (84.2%) beginning later in reproductive life (mean age-45yrs) is the classic presentation. Adenomyosis was present in 10 of 61 patients (16.3%) with fibroids; 27 of 60 (45%) with abnormal uterine bleeding; 11 of 55 (20%) with prolapse; four of 35 (11.4%) with ovarian mass; five of 25 (20%) with chronic pelvic pain; three of four (75%) with endometriosis. ConclusionWomen undergoing hysterectomy with diagnosis of adenomyosis have a distinct symptomatology. The choice of therapy in adenomyosis is hysterectomy for those women who have completed family and had failed medical therapy .

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Section: Discussionmentioning

confidence: 99%

Adenomyosis at Hysterectomy: Prevalence, Patient Characteristics, Clinical Profile and Histopatholgical Findings

Shrestha

Sedhai

et al. 2012

Kathmandu Univ. Med. J.

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“…Parazzini F, et al reported that women with adenomyosis did not have dyspareunia but had more chronic pelvic pain and dysmenorrhea. 6 Bergholt T et al reported that endometrial hyperplasia had a significant association with adenomyosis. Our study found more of proliferative type of endometrium in hysterectomy specimen with adenomyosis.…”

Section: Discussionmentioning

confidence: 99%

“…5 Risk factors for adenomyosis are age, multiparity, surgical disruption of the endometrial-myometrial border, elevated levels of both FSH and prolactin, smoking habits and history of depression. 6,7 Clinical diagnosis of adenomyosis is challenging because symptoms closely mimic those of other uterine pathology such as fibroid uterus, endometriosis or endometrial polyps. Oral contraceptive pills, gonadotropin hormones, progesterone pills, progesterone intrauterine devices are the main stay of medical treatment of symptoms as uterus is a hormonally responsive organ.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of adenomyosis as a co-morbidity in patients who underwent hysterectomy for other indications

2020

IJOGR

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Introduction: Adenomyosis is a common gynaecological condition that affects women of reproductive age group (20%-60%). The cardinal clinical features of adenomyosis are menorrhagia, dysmenorrhea and uterine enlargement. Classically, it was thought and compared with ultrasonography; MRI enables more accurate diagnosis of the disease when adenomyosis is suspected. Objective: To evaluate the clinical profile associated with adenomyosis, frequency distribution and to determine the prevalence of adenomyosis in patients undergoing hysterectomy for other indications, as well as to correlate clinical examination with histopathological examination. Methodology: It is a retrospective observational study which included 100 patients who underwent abdominal hysterectomy or vaginal hysterectomy for various indications. Age, parity, presenting complaints, elicited signs, indication for hysterectomy, and HPE report of the specimens were analyzed. All cases diagnosed as Adenomyosis and Endometriosis was excluded. Results: Among 100 women who underwent hysterectomy, Adenomyosis was found in 24 cases (24%). Menorrhagia (91.7%), chronic pelvic pain (83.3%), dysmenorrhea (79.2%), dyspareunia (16.7%) is the classic presentation. More common in multiparous women and begins later in reproductive life (mean age-45yrs). (45.8%) had bulky uterus on per vaginal examination. Adenomyosis was present in 10 of 23 patients (43.47%) diagnosed as dysfunctional uterine bleeding; 6 of 24 (25%) with fibroid; 4 of 21 (19.04%) with prolapse; 2 of 14 (14.28%) with ovarian mass; 2 of 10 (20%) with pelvic inflammatory disease. Conclusion:The prevalence of unsuspected adenomyosis is found to be 24% in this study. Adenomyosis is common in women presenting with chronic pelvic pain, menorrhagia and dysmenorrhea. It is also common in multiparous women with bulky uterus and mean age being 45 years. In women with completed family and had failed medical therapy given for undiagnosed Adenomyosis the choice of therapy is hysterectomy.

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“…The prevalence of ADS in hysterectomy specimens was found to be 28.2% in a study (2). Studies have demonstrated the occurrence of invasive adenomyotic lesions associated with increased levels of matrix metalloproteinases (MMPs) and showed increased levels of vascular endothelial growth factor (VEGF) in patients with ADS (3,4).…”

Section: Introductionmentioning

confidence: 98%

The effect of adenomyosis on the outcomes of laparoscopic hysterectomy

Yavuzcan

Başbuğ

Baştan

et al. 2016

J Turkish German Gynecol Assoc

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Determinants of adenomyosis in women who underwent hysterectomy for benign gynecological conditions: Results from a prospective multicentric study in Italy

Cited by 104 publications

References 11 publications

Adenomyosis at Hysterectomy: Prevalence, Patient Characteristics, Clinical Profile and Histopatholgical Findings

Adenomyosis at Hysterectomy: Prevalence, Patient Characteristics, Clinical Profile and Histopatholgical Findings

Prevalence of adenomyosis as a co-morbidity in patients who underwent hysterectomy for other indications

The effect of adenomyosis on the outcomes of laparoscopic hysterectomy

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