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

Krentel, Harald; Wilde, Rudy Leon De

doi:10.1016/j.amsu.2022.103809

Cited by 13 publications

(14 citation statements)

References 45 publications

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“…This rate is within the range, though at the high end, of the general prevalence reported in prospective and retrospective studies (23.4%–43.3%) and seems to be higher than that reported specific to the CPP population (6.5%–20%). 7 –9 Dysmenorrhea, heavy menstrual bleeding, and subfertility are clinical symptoms that have classically been associated with adenomyosis, 2,7,13 however, there was no association between these symptoms nor other pain characteristics within our cohort. These findings suggest that among patients with chronic pelvic pain, clinical symptoms to identify adenomyosis may be unreliable for diagnosis.…”

Section: Discussionmentioning

confidence: 56%

“…A 59.3% of patients in this study who reported dysmenorrhea and abnormal bleeding were diagnosed with adenomyosis, and adenomyosis was found in only 6.5% who described pain as their primary symptom. 9 For specific subpopulations, such as CPP patients, the clinical significance of this diagnosis increases, as this population is inherently symptomatic. Additionally, it would be reasonable to theorize that the prevalence of adenomyosis may be higher in chronic pelvic pain patients compared to the general population.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of histologically confirmed adenomyosis in a chronic pelvic pain cohort

Stewart¹,

Castellanos

Nadella

et al. 2023

Journal of Endometriosis and Pelvic Pain Disorders

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Introduction: We aimed to determine the prevalence of pathology confirmed adenomyosis in women with chronic pelvic pain (CPP) who underwent surgical management with total hysterectomy, and to identify associated risk factors and demographic variables. Methods: This is a retrospective cohort study involving 1186 patients treated in a CPP-specialty clinic who underwent surgical management with hysterectomy between January 2010 and December 2021. Results: About 532/1186 (44.9%) of the cohort were diagnosed with adenomyosis on pathology following total hysterectomy. The average age of patients with adenomyosis was older than those without adenomyosis [41 years vs 38 years ( p < 0.001)]. There were no statistically significant differences in symptoms of menstrual bleeding, pelvic pain, dysmenorrhea, or dyspareunia. Those with adenomyosis were more likely to be Hispanic ( p < 0.001), have a history of pregnancy ( p < 0.001), and have chronic cervicitis ( p = 0.037). Uterine weight was significantly higher in the group with adenomyosis ( p = 0.033) especially when excluding leiomyoma ( p = 0.006). Discussion: The prevalence of adenomyosis on surgical pathology in a CPP cohort was higher than that reported for the general population. Uterine weights are higher in adenomyosis, even when controlling for leiomyoma. Classically attributed symptoms of adenomyosis were not useful predictors for the disease.

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Section: Discussionmentioning

confidence: 56%

Section: Introductionmentioning

confidence: 99%

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Prevalence of histologically confirmed adenomyosis in a chronic pelvic pain cohort

Stewart¹,

Castellanos

Nadella

et al. 2023

Journal of Endometriosis and Pelvic Pain Disorders

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“…Although hysterectomy has been an effective treatment for heavy menstrual bleeding, it has only been in the last 2-3 decades that the focus has gradually shifted towards the non-surgical treatment of heavy menstrual bleeding. That is not only cost effective but also preserves the uterus and fertility for patients whenever possible [12,13]. LNG-IUS is a minimally invasive treatment method that reduces heavy menstrual bleeding up to 90% with its progestogenic effect on the uterine endometrium.…”

Section: Discussionmentioning

confidence: 99%

The role of FIGO-PALM pathologies in heavy menstrual bleeding resistant to levonorgestrel-releasing intrauterine system (Mirena®) treatment

Özgen

2023

The European Research Journal

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Objectives: To evaluate of the indications requiring surgical treatment after Levonorgestrel-Releasing Intrauterine System (LNG-IUS) (Mirena®) treatment due to heavy menstrual bleeding. Methods: This retrospectively designed study was created with 72 patients who applied to the university hospital gynecology outpatient clinics between January 2018 and April 2019 and were diagnosed with heavy menstrual bleeding and received LNG IUS (Mirena®) for treatment. Results: Surgery was not performed in 60 (83.33%) patients who had heavy menstrual bleeding and underlying organic pathology (FIGO-PALM group) These patients were treated with LNG-IUS. However, in 12 (16.67%) patients, LNG-IUS was removed and surgery was performed due to resistance to treatment within an average of 10.2 ± 8.0 months. There was no difference between the groups in terms of age, gravida, parity, body mass index and endometrial thickness (p > 0.05 for all parameters), but the mean hemoglobin value in the surgical group was found to be significantly lower than the group without it (8.9 ± 1.2 g/dL vs 11 ± 1.6 g/dL, p = 0.03) In the surgical group, the median diameters of leiomyoma and myoma compressing the endometrium were found to be significantly higher (44 mm vs 34 mm, p = 0.03 and 42 mm vs 33 mm, p = 0.04; respectively). Conclusions: LNG-IUS (Mirena®) is a popular and effective treatment option for heavy menstrual bleeding. The necessity of surgical treatment due to resistance to LNG-IUS revealed that the underlying organic pathologies in these patients should be determined precisely and effective treatment options should be carefully selected before LNG-IUS is inserted.

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“…The studies included women between the ages of 40 and 55 years who present with AUB and are scheduled for hysterectomy. Transvaginal ultrasound can be performed prior to surgery, and the sonographic findings will be compared with the histopathological examination of the hysterectomy specimens [5][6] . The primary outcome will be the correlation between sonographic findings and histopathological examination in diagnosing endometrial hyperplasia, endometrial polyps, and uterine fibroids.…”

Section: Introductionmentioning

confidence: 99%

Correlation of Sonographic Findings and Histopathological Examination of Hysterectomy Specimens in Perimenopausal Patients with Abnormal Uterine Bleeding

Johar¹,

Riaz²,

Akhtar³

et al. 2023

PJMHS

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Background: Abnormal uterine bleeding (AUB) is a frequent prenatal problem that affects the women of all ages. AUB is the condition in which vaginal bleeding occur in the absence of pregnancy. The most common and easily available imaging procedure is the ultrasonography. Our study aimed to investigate the correlation between sonographic findings and histopathological examination of hysterectomy specimens in perimenopausal women with AUB. Study design: It is a cross-sectional study conducted at Lady Willingdon Hospital Lahore and Divisional Headquarters Teaching Hospital Mirpur, Azad Kashmir for the duration of six months from July 2022 to December 2022. Material and Methods: This study on hysteroscopy was carried out on 50 patients suffering from uterine bleeding and having a biopsy. All the patients selected in the given study were according to the inclusion criteria, while those patients were excluded that do not fulfill the inclusion criteria. Most of the patients included in this study had ages between 31 to 41 years. The study was approved by the review and ethical board committee of the hospital. Results: Most patients having this ultrasonography had fibroid and bulky uterus. Only a few had Adenomyosis and thick endometrium. Neglectable patients had an endometrial polyp and malignancy issues. The sensitivity value for the normal endometrium used as a control was at an acceptable range and it was used as the control for the further evaluation of other attributes. Conclusion: For the diagnosis of abnormal uterine bleeding, hysteroscopy is an excellent diagnostic tool and it is highly efficient for the estimation of pathological issues of the endometrium wall. Keywords: Abnormal uterine bleeding, sonography and histopathological examination.

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

Cited by 13 publications

References 45 publications

Prevalence of histologically confirmed adenomyosis in a chronic pelvic pain cohort

Prevalence of histologically confirmed adenomyosis in a chronic pelvic pain cohort

The role of FIGO-PALM pathologies in heavy menstrual bleeding resistant to levonorgestrel-releasing intrauterine system (Mirena®) treatment

Correlation of Sonographic Findings and Histopathological Examination of Hysterectomy Specimens in Perimenopausal Patients with Abnormal Uterine Bleeding

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