Patients with adenomyosis are more likely to have deep endometriosis

Abstract

This study seeks to analyze the association between adenomyosis diagnosed by magnetic resonance imaging (MRI) and endometriosis. This is a prospective study of consecutive patients. One hundred fifty-two patients with histologically confirmed endometriosis. Patients were submitted to MRI, then divided into Group A (with adenomyosis) and Group B (without adenomyosis). Thickness of the junctional zone and the presence of intramyometrial cysts were the principal criteria for diagnosis of adenomyosis. MRI data were correlated with clinical status, staging, sites affected, and histological classification of endometriosis. The prevalence of adenomyosis in endometriosis patients was 42.76 %. Patients with endometriosis and adenomyosis were more likely than those without adenomyosis to report severe or incapacitating dysmenorrhea (61.53 % in Group A; 44.83 % in Group B; p00.041) and deep dyspareunia (64.61 % in Group A; 41.38 % in Group B; p00.005), to have stage IV endometriosis (50.77 % in Group A; 33.34 % in Group B; p00.03), to have endometriosis of the rectosigmoid (49.23 % in Group A; 32.18 % in Group B; p00.033), and to have undifferentiated or mixed histological types of endometriosis (52.31 % in Group A; 34.48 % in Group B; p00.028). A correlation was found between adenomyosis and deep endometriosis with poorer prognosis, particularly endometriosis of the rectosigmoid.

The pathophysiology of uterine adenomyosis: an update

“…Nevertheless, the investigators could not conclude that their study supported a common pathogenesis of adenomyosis and endometriosis because the invasive potential of endometrial cells in the uterus and peritoneum corresponded only to a limited extent. A 42.76% prevalence of adenomyosis in patients with endometriosis has been recently identified in patients reporting severe or incapacitating dysmenorrhea and deep dyspareunia and in patients with endometriosis of the rectosigmoid (97).…”

Percutaneous microwave ablation with artificial ascites for symptomatic uterine adenomyosis: initial experience

“…Nevertheless, this procedure may sometimes be difficult due to bowel interference, especially in cases with pelvic adhesions. Unfortunately, pelvic surgery (especially caesarean section) and pelvic endometriosis are commonly observed in association with adenomyosis [25][26][27][28]. Both pelvic surgery and pelvic endometriosis can cause pelvic adhesions.…”

Endometriotic Pain Is Associated with Adenomyosis but Not with the Compartments Affected by Deep Infiltrating Endometriosis

“…It is well-defined that there is an overlap in the pathogenesis of endometriosis and adenomyosis, which is particularly important in DIE [19][20][21] . Gonzales et al [22] found a correlation between uterine adenomyosis and DIE, particularly in the rectosigmoid. Although 30-50% of women with adenomyosis are asymptomatic [11,[23][24][25] , the severe form of the disease often shows symptoms correlated with the intensity and depth of the lesions [22] .…”

“…Gonzales et al [22] found a correlation between uterine adenomyosis and DIE, particularly in the rectosigmoid. Although 30-50% of women with adenomyosis are asymptomatic [11,[23][24][25] , the severe form of the disease often shows symptoms correlated with the intensity and depth of the lesions [22] . We observed a statistically significant correlation between pelvic pain and the presence of adenomyosis, in agreement with the previously reported results [23,26,27] .…”