Adenomyosis-Induced Urinary Retention: Case Analysis and Clinical Implications

Feihong Xu, Weiyong Zhong, Shujiang Ye, Ruihan Zhong, Rongfang Zhong, Yi Jiang, Zhenquan Lu, Lin Xiong, Xiang Xu
The American journal of case reports · 2024 · vol. 26 , pp. e946476 · doi:10.12659/ajcr.946476 · PMID:39838607 · PMC11760045 · W4405620798
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This case report details a patient whose acute urinary retention resolved after a total hysterectomy, highlighting adenomyosis as a rare but potential cause of urinary dysfunction in women.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 ⓘ

This 2025 paper is a single-patient case report investigating recurrent acute urinary retention in a 43-year-old woman with a 20-year history of dysmenorrhea and menorrhagia diagnosed with adenomyosis, using clinical evaluation plus ultrasound and CT to assess pelvic anatomy and exclude urinary infection. Imaging showed a markedly enlarged, globular uterus with very thick posterior myometrium and disorganized vascularization, and the authors concluded the enlarged posterior uterus was compressing the urethra; urine tests were normal, and uroflow during symptom relief showed no post-void residual. The patient underwent laparoscopic total hysterectomy after conservative measures were ineffective, and postoperative follow-up reported complete resolution of urinary retention with normal urinary function and no recurrence. This paper is centrally about endometriosis or adenomyosis — specifically, adenomyosis causing recurrent urinary retention that improved after hysterectomy.

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Abstract

BACKGROUND Acute urinary retention (AUR) is relatively rare in non-pregnant women and is usually associated with lower urinary tract dysfunction, neurological issues, or pelvic organ compression. Adenomyosis is a common gynecologic condition characterized by the invasion of endometrial glands and stroma into the myometrium, often accompanied by symptoms such as dysmenorrhea and heavy menstrual periods. Although adenomyosis is common, its involvement in causing urinary retention is rare but deserves clinical attention. CASE REPORT We report the case of a patient with recurrent urinary retention due to adenomyosis, who had a 20-year history of dysmenorrhea and menorrhagia. Imaging revealed significant thickening of the posterior uterine wall and a globular increase in size. Due to the ineffectiveness of conservative treatment, the patient ultimately underwent a total hysterectomy via laparoscopy. After the operation, the patient's urinary retention symptoms completely disappeared, her urinary function quickly returned to normal, and her postoperative follow-up showed no recurrence of urinary retention or other urinary-related symptoms. CONCLUSIONS Although adenomyosis is common in women, acute urinary retention remains rare. This case report suggests that clinicians should consider adenomyosis as a potential cause alongside other common causes of recurrent or unexplained urinary retention in female patients, particularly in those presenting with classic symptoms such as prolonged dysmenorrhea and menorrhagia. The successful treatment of this case further highlights the importance of an individualized treatment plan, as total hysterectomy can effectively relieve symptoms and improve the patient's quality of life.

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Condition tags

dysmenorrheaadenomyosis

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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