Neuro-etiologic classification of adenomyosis: the “Shanghai system”

ZHANG Lin Na, C. Y. Lan, CHEN Lan, Xu Hong, Wang Yuan, ZHANG Hui Juan, MJ Quinn
In: Clinical Obstetrics, Gynecology and Reproductive Medicine · 2019 · vol. 5(4) · doi:10.15761/cogrm.1000260 · W3004628266
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Abstract

Some patterns of uterine adenomyosis (AM) are more common in China than Europe or USA. In this new classification derived from clinical observations in Shanghai, there are four patterns of adenomyosis, and, three out of the four have neurologic abnormalities associated with specific injuries to uterotubal nerves "Shanghai system" (SS), types 1-4, AM). Typically, European or US women present with "painful" uterine bleeding in their 30-40's that results in hysterectomy at reduced uterine weights (80-150g). Histology shows aberrant reinnervation throughout the body of the uterus and uterosacral ligaments, as a result of intrapartum injuries, or, excessive traction applied to the cervix, or, over-vigorous curettage (SS, type 2, AM).

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