Characterization of patients that can continue conservative treatment for adenomyosis

Chiho Miyagawa, Kosuke Murakami, Takako Tobiume, Takafumi Nonogaki, Noriomi Matsumura
In: medRxiv · 2021 · doi:10.1101/2021.03.03.21252870 · W3134171023
preprint OA: green CC0
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This study identified that multiparous women and those diagnosed at older ages are more likely to require hysterectomy after initiating conservative adenomyosis treatment.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective study selected women diagnosed with adenomyosis who began conservative treatment at Kindai University Hospital and Osaka Red Cross Hospital between 2008 and 2017, and examined factors such as age at diagnosis, parity, uterine size, adenomyosis subtype (by MRI), type of conservative therapy, and timing of hysterectomy when conservative treatment became difficult. Among 124 women who started conservative treatment, 96 (77.4%) continued it, while 28 (22.6%) required hysterectomy, with a cumulative hysterectomy rate of 32.4% and all hysterectomies occurring within 63 months. Decision-tree analysis suggested that age at diagnosis and parity stratified the likelihood of continuing conservative management, with women aged ≤46 more likely to continue when parity was 0–1, whereas multiparous women diagnosed at older ages had a high likelihood of hysterectomy. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Abstract Introduction Historically, hysterectomy has been the radical treatment for adenomyosis. However, some patients do not wish to hysterectomy. Nevertheless, patients often required hysterectomy during the course of conservative treatment, but the factors involved remain unknown. The purpose of this study was to determine which patients can continue conservative treatment for adenomyosis. Materials and Methods We selected women diagnosed with adenomyosis and provided with conservative treatment at the Kindai University Hospital and Osaka Red Cross Hospital. Age at diagnosis, parity, uterine size, subtype of adenomyosis, type of conservative treatment, and timing of hysterectomy for cases with difficulty continuing conservative treatment were examined retrospectively. Results A total of 885 patients were diagnosed with adenomyosis, and 124 started conservative treatment. Conservative treatment was continued in 96 patients (77.4%) and hysterectomy was required in 28 patients (22.6%). The cumulative hysterectomy rate was 32.4%, and all women had hysterectomy within 63 months. In the decision tree analysis, 82% (23/28) of women aged 46 years or younger were able to continue conservative treatment when parity was zero or one. If parity was two and over, 95% (20/21) of those aged 39 years and older had hysterectomy. Conclusions Patients that continue conservative treatment for approximately 5 years are more likely to have successful preservation of the uterus. Multipara and higher age of diagnosis are factors that contribute to hysterectomy after conservative treatment. Parity and age at diagnosis may be stratifying factor in future clinical trials on hormone therapy.

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Condition tags

adenomyosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (30)

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