Diagnosis and treatment of uterine adenoeyosis in 87 cases

Objective To investigate the incidence, clinical characteristics,diagnosis and treatment of uterine adenomyosis. Methods Clinical data of 87 patients with adenomyosis comfirmed by pathology from January 2000 to December 2002 admitted in our hospital were analyzed retrospectively. Results The incidence of adenomyosis was 9. 6% of total gynecological hospitalized patients and accounted for 21. 3% among all patients. Fifty-eight (66. 7%) cases of hystercectomy had dysmenorrhea and 35 (40. 2%)had menorrhagia. Three(3. 4%) had colic pain after induced abortion. Fifty-one cases were diagnosed as adenomyosis preoperatively,with 58. 6% diagnostic accuracy. The serum CA125 was positive in 69. 2%. All except 3 patients were treated with hysterectomy. Before operation, 32 patients had received hormone treatment, as gestrinone, danazol, mifepristone, estrogen or progestins for more than three months. Dysmenorrhea was relieved in 76. 0% of patients during the hormone medicinal treatment. But symptoms recurred in 73. 7% of cases at the first menstrual cycle after the cessation of treatment. Conclusion Hyserectomy remains the dominant treatment of adenomyosis up to now. Drugs for endometrioais is also effective for relieving dysmenorrhea in patients with uterne adenomyosis although the dysmenorrhea recurs rapidly when medical treatment is stopped.