OP07.01: New sonographic classification of adenomyosis: do type and degree of adenomyosis correlate to severity of symptoms?

To correlate type and degree of adenomyosis, scored through a new system based on transvaginal sonographic (TVS) features, to patient's symptoms and fertility. This is a multicentre, prospective study performed in two Endometriosis tertiary referral centre (Canadian Task Force II-2) including 108 patients with ultrasound diagnosis of adenomyosis and 40 controls without any sonographic signs of myometrial pathologies. A new ultrasonographic scoring system designed to assess the severity and the extension of uterine adenomyosis was used to stage the disease in correlation with clinical symptoms. Menstrual uterine bleeding was assessed by a pictorial blood loss analysis chart (PBAC), painful symptoms were evaluated using a visual analogue scale (VAS) and infertility factors were considered. 108 patients with adenomyosis (mean age 37.7±7.7 yrs) were classified according to the proposed scoring system. The 22 patients with a score of focal-mild adenomyosis were younger compared to the patients with severe disease and showed a higher percentage (75.86%) of severe dysmenorrhea (VAS>5) and infertility (24.13%). The 20 patients with severe-diffuse adenomyosis, according to the score, showed in 95.24% of cases heavy menstrual bleeding (PBAC>100) and in 80.95% severe dysmenorrhea. All the 21 patients with adenomyomas had a PBAC>100. The evaluation of the extension of adenomyosis in the myometrium and in the JZ seems important in correlation to the severity of symptoms and infertility, as well as for an emerging request of surgical treatment. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.