Adenomyosis: diagnostics and treatment

Abstract

Background Adenomyosis is a frequent additional condition in patients with endometriosis and should be included in diagnostic and treatment concepts. Objective Description of diagnostic and therapeutic approaches in patients with adenomyosis in relation to patient age, family planning status, peritoneal and/or deep endometriosis and symptoms. Methods The current literature on adenomyosis including case reports was analyzed. Due to the lack of evidenced-based approaches the most probable trends in diagnostics and treatment are discussed. Results Adenomyosis plays an important role in fertile patients with dysmenorrhea, dyspareunia and pelvic pain, with or without additional peritoneal or deep endometriosis. It has a negative impact on fertility and can cause a variety of symptoms. The disease can be diagnosed by a skilled examiner and treatment concepts exist. Conclusion Adenomyosis can be diagnosed by a combination of clinical history, gynecological examination, transvaginal ultrasound and magnetic resonance imaging. Various medical and surgical treatment approaches are available to reduce symptoms and to increase fertility. The course of action depends on the family planning status of the patient.

Prevalence of adenomyosis in women undergoing hysterectomy for abnormal uterine bleeding, pelvic pain or uterine prolapse – A retrospective cohort study

“…In a 10-year meta-analysis the pooled sensitivity (83.8%) and pooled specificity (63.9%) showed a good accuracy of the transvaginal ultrasound in the hands of the skilled examiner [ 16 ]. Additional sonographic techniques like doppler-ultrasound, elastography and 3D transvaginal ultrasound can enhance the diagnostic reliability [ 17 , 18 ]. These diagnostic criteria might be missing in adolescents and young women [ 19 , 20 ].…”