Progression of adenomyosis: Rate and associated factors

Borghese G, Giulia Borghese, Marisol Doglioli, Benedetta Orsini, Orsini B, Antonio Raffone, Daniele Neola, Travaglino A, Antonio Travaglino, Rovero G, Giulia Rovero, Del Forno S, Simona Del Forno, de Meis L, Lucia de Meis, Mariavittoria Locci, Locci M, Maurizio Guida, Jacopo Lenzi, Renato Seracchioli, Seracchioli R, Raimondo D, Diego Raimondo
International Journal of Gynecology & Obstetrics · 2024 · vol. 167(1) , pp. 214–222 · doi:10.1002/ijgo.15572 · PMID:38738458
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⚙ AI-generated summary by claude@2026-06, 2026-06-13 ⓘ

This study found a 21.3% progression rate for adenomyosis over 12 months, which was higher in untreated women and associated with specific symptoms and outer myometrial involvement.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-11 · read from full text ⓘ

This single-center, prospective observational cohort study evaluated the rate of adenomyosis progression over 12 months in 221 patients with ultrasound-diagnosed adenomyosis, recording demographic, clinical, and ultrasound data at baseline (T0) and follow-up (T1). Progression was defined by an increase in uterine volume greater than 20%, and patients were categorized as progression versus stability/regression; the overall progression rate was 21.3% (47/221), with higher progression in hormonally untreated women (30.77%) than hormonally treated women (18.34%). Adenomyosis progression at T1 was associated with focal adenomyosis of the outer myometrium, moderate-to-severe dysmenorrhea, chronic pelvic pain, dyschezia, and worsening chronic pelvic pain. This paper is centrally about endometriosis and/or adenomyosis—specifically adenomyosis progression rate and associated clinical and ultrasound factors.

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Abstract

OBJECTIVE: To evaluate the rate of disease progression and the factors associated with such progression in patients with an ultrasound diagnosis of adenomyosis. METHODS: This was a single center, prospective, observational, cohort study performed at a tertiary referral center. Patients who obtained an ultrasound diagnosis of adenomyosis from May 2022 to August 2022 were recruited. Demographic, clinical and ultrasound data were recorded at the first visit (T0) and after 12 months (T1) for enrolled patients and compared between T0 and T1. The study population was divided in two groups according to progression (increase in uterine volume >20%) or stability/regression (decrease or increase in uterine volume ≤20%) of adenomyosis at T1. Primary study outcome was the rate of adenomyosis progression, while secondary study outcome was the association of adenomyosis progression with demographic and clinical factors. Post hoc subgroups analyses for primary and secondary study outcomes were performed based on hormonal therapy (untreated and treated). RESULTS: A total of 221 patients were enrolled in the study, with no significant difference in terms of baseline data among the two study groups and no patients were lost to follow-up. The overall rate of adenomyosis progression was 21.3% (47/221 patients). The rate was 30.77% in hormonally untreated women, and 18.34% in hormonally treated women. Progression was associated with the presence of focal adenomyosis of the outer myometrium (P = 0.037), moderate to severe dysmenorrhea (P = 0.001), chronic pelvic pain (P = 0.05), dyschezia (P = 0.05), and worsening of chronic pelvic pain (P = 0.04) at T1. CONCLUSION: Adenomyosis showed a rate of disease progression of 21.3% at the 12-month follow-up (30.77% in hormonally untreated women, and 18.34% in hormonally treated women). The presence and/or worsening of painful symptoms, such as severe dysmenorrhea, dyschezia and chronic pelvic pain, as well as the presence focal adenomyosis of the outer myometrium, might help identify patients at higher risk of disease progression and tailor their follow-up.
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Abstract

Objective To evaluate the rate of disease progression and the factors associated with such progression in patients with an ultrasound diagnosis of adenomyosis.

Methods

This was a single center, prospective, observational, cohort study performed at a tertiary referral center. Patients who obtained an ultrasound diagnosis of adenomyosis from May 2022 to August 2022 were recruited. Demographic, clinical and ultrasound data were recorded at the first visit (T0) and after 12 months (T1) for enrolled patients and compared between T0 and T1. The study population was divided in two groups according to progression (increase in uterine volume >20%) or stability/regression (decrease or increase in uterine volume ≤20%) of adenomyosis at T1. Primary study outcome was the rate of adenomyosis progression, while secondary study outcome was the association of adenomyosis progression with demographic and clinical factors. Post hoc subgroups analyses for primary and secondary study outcomes were performed based on hormonal therapy (untreated and treated).

Results

A total of 221 patients were enrolled in the study, with no significant difference in terms of baseline data among the two study groups and no patients were lost to follow-up. The overall rate of adenomyosis progression was 21.3% (47/221 patients). The rate was 30.77% in hormonally untreated women, and 18.34% in hormonally treated women. Progression was associated with the presence of focal adenomyosis of the outer myometrium (P = 0.037), moderate to severe dysmenorrhea (P = 0.001), chronic pelvic pain (P = 0.05), dyschezia (P = 0.05), and worsening of chronic pelvic pain (P = 0.04) at T1.

Conclusion

Adenomyosis showed a rate of disease progression of 21.3% at the 12-month follow-up (30.77% in hormonally untreated women, and 18.34% in hormonally treated women). The presence and/or worsening of painful symptoms, such as severe dysmenorrhea, dyschezia and chronic pelvic pain, as well as the presence focal adenomyosis of the outer myometrium, might help identify patients at higher risk of disease progression and tailor their follow-up. CONFLICT OF INTEREST STATEMENT The authors confirm that there are no conflicts of interest. DATA AVAILABILITY STATEMENT The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Condition tags

dysmenorrheachronic_pelvic_painadenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis Adenomyosis

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