VP63.02: Incidence of adenomyosis and correlation between symptoms, ultrasound images, surgical findings and pathological analysis

To determine the incidence of adenomyosis and its correlation between symptoms, ultrasound images, surgical findings and pathological analysis. We performed a retrospective study of 92 women with prior hysterectomy in a tertiary referring centre during five years (2015–2019) diagnosed of adenomyosis. A complete medical history were recorded. Symptoms, ultrasound images, surgical findings and treatment were assessed. of 1075 patients with prior hysterectomy, 92 were diagnosed of adenomyosis confirmed on surgical specimen (8.56%). Mean age of women with adenomyosis was 51.93 years. The most common principal symptoms were menorrhagia/abnormal uterine bleeding (53.26%) and dysmenorrhea/pelvic pain (28.26%). More than 50% of women experienced both. In relation to ultrasound diagnosis, 15.22% had preoperative imaging findings of diffuse adenomyosis and another 10.87% had features indicative of focal adenomyosis. 63.04% of patients had uterine fibroids described on ultrasound images and five of them presented ovarian endometriomas. Regarding surgical findings, all patients with ovarian endometriomas were confirmed during the surgery. Another four patients presented deep infiltrating endometriosis with rectosigmoid nodules and 28 women had pelvic adhesions. As described in ultrasound diagnoses, 48 patients (52.17%) had uterine fibroids coexisting during uterine specimen analysis. While 6 of the 92 patients had extense adenomyosis, the other 86 patients had focal adenomyosis. In our experience, the incidence of adenomyosis is similar as what is described in the bibliography. The progress of ultrasound images has allowed non-invasive diagnosis of adenomyosis, especially in women with associated symptoms as menstrual pain or heavy menstrual bleeding. Adenomyosis may be associated with endometriosis (endometriomas, deep infiltrating endometriosis or pelvic adhesions) but specially with uterine fibroids. Adenomyosis is not always easy to differentiate from leyomiomas in ultrasound scans.