Characteristics indicating adenomyosis at the time of hysterectomy: a retrospective study of 291 patients

FA Taran, Ralf Rothmund, Katharina Rall, SY Brucker, Markus Wallwiener
In: Geburtshilfe und Frauenheilkunde · 2011 · vol. 71(08) · doi:10.1055/s-0031-1286401 · W2320016649
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This retrospective study compared 291 hysterectomy patients to elucidate the clinical characteristics distinguishing adenomyosis from uterine leiomyomas.

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This retrospective study analyzed clinical profiles of 291 women undergoing hysterectomy to differentiate adenomyosis from uterine leiomyomas. The researchers compared sociodemographic and pathologic variables across three groups: adenomyosis alone, combined adenomyosis and leiomyomas, and leiomyomas alone. Key findings indicated that patients with isolated adenomyosis were more likely to be older, parous, smokers, and experience significant pelvic pain, while exhibiting lower uterine weight compared to those with only fibroids. This paper is centrally about adenomyosis — specifically examining its distinct clinical characteristics relative to uterine leiomyomas at the time of hysterectomy.

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Abstract

The objective of this study was to elucidate the clinical profile of adenomyosis by comparison with uterine leiomyomas.
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Introduction

The objective of this study was to elucidate the clinical profile of adenomyosis by comparison with uterine leiomyomas.

Material and methods

We conducted a retrospective study of women undergoing hysterectomy for benign disease with a histologic diagnosis of adenomyosis, a diagnosis of both adenomyosis and leiomyomas and women with uterine leiomyomas but no adenomyosis. A retrospective medical record review was performed to ascertain sociodemographic and anthropometric variables, as well as to confirm intraoperative and pathologic findings.

Results

Our study sample comprised 291 patients, 38 women with adenomyosis, 56 women with adenomyosis and leiomyomas and 197 women with only leiomyomas. In multinomial logistic regression analyses, women with adenomyosis were associated with older age [odds ratio (OR) 0,9; 95% confidence interval (CI) 0,8–1,0], a history of smoking (OR 3,72; 95% CI 1,2–11,3), were more likely to be parous (OR 7,5; 95% CI 2,4–23,6) when compared with women with adenomyosis and leiomyomas. Women with leiomyomas were associated with older age (OR 0,9; 95% CI 0,9–1,0) when compared with women with adenomyosis and leiomyomas. Finally, women with adenomyosis had a lower uterine weight (OR 1,0; 95% CI 0,9–1,0), were more likely to have more pelvic pain (OR 4,8; 95% CI 1,5–15,2), were more likely to have a history of smoking (OR 2,6; 95% CI 1,1–6,5) and were more likely to be parous (OR 4,3; 95% CI 1,5–12,3) when compared with women with leiomyomas.

Conclusions

Women undergoing hysterectomy with adenomyosis and with both adenomyosis and leiomyomas have a number of different features compared with women with only leiomyomas at the time of hysterectomy. Better understanding of this disease is required to improve diagnosis and management.

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adenomyosis

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