Sonography for the diagnosis of adenomyosis

I read with great interest the paper of Bazot et al.1 entitled 'Limitations of transvaginal sonography for the diagnosis of adenomyosis, with histopathological correlation'. Certainly, I also think that sonographic diagnosis of adenomyosis is easier and more accurate in a selected group of women affected by menometrorrhagia with suspicion of adenomyosis. Unfortunately, adenomyosis is often associated with other uterine disorders for which sonographic diagnosis is difficult and less accurate. Regarding the risk factors for adenomyosis, the authors do not report information about the history of previous surgery in their patients affected by adenomyosis. In our paper2, in those women with a histopathological diagnosis of adenomyosis we observed that 8/15 (53.3%) women reported a history of endometrial curettage, Cesarean section, and myomectomy. I would like, if possible, to have further information from the authors regarding their patients' previous histories. In Table 3 'Assessment of adenomyosis at ultrasound' in Bazot et al.'s paper1, I would like to clarify the data regarding our own paper2. In our experience, the prevalence of adenomyosis was 22.4% for the group of selected women (n = 58) affected by menometrorrhagia and with a clinical suspicion of adenomyosis; whereas the prevalence was 8.6% for all the patients (n = 175) scheduled for hysterectomy for benign pathology. Therefore the true prevalence was 22.4%, which remains lower than, if more in line with, data reported by other authors cited in Table 3. E. Atzori*, * Department of Obstetrics and Gynecology, Ospedale S. Barbara, Iglesias (CA)