Clinical and morphological features of combined hyperplastic diseases of the uterus against the background of adenomyosis

In: Journal of Education, Health and Sport · 2020 · vol. 10(4) , pp. 226–233 · doi:10.12775/jehs.2020.10.04.025 · W3032477198
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This study examined 62 premenopausal women with abnormal uterine bleeding and adenomyosis, finding that lipid and carbohydrate metabolism disorders worsen the condition and correlate with adenomyosis activity and comorbid pathologies.

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This study assessed clinical and morphological characteristics of combined hyperplastic uterine diseases in 62 premenopausal women with chronic abnormal uterine bleeding, compared with 30 premenopausal controls undergoing preventive examination, using anthropometrics, ultrasound, metabolic evaluation (carbohydrate and lipid metabolism), and histology. The authors found that patients with uterine hyperplasia more often had lipid metabolism abnormalities (dyslipidemia) and carbohydrate metabolism disturbances associated with alimentary–constitutional obesity and metabolic syndrome, which were linked to a worse clinical course of the main disease. Histologically, the activity of adenomyosis foci correlated with the severity of clinical manifestations, including abnormal uterine bleeding and pain, and with coexisting lesions such as endometrial hyperplasia, chronic endometriosis, fibroids, and endometriosis. This paper is centrally about endometriosis and adenomyosis — it specifically examines how adenomyosis activity relates to combined uterine hyperplastic pathology.

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Abstract

To determine clinical and morphological features of combined uterine hyperplastic diseases in premenopausal women at the background of adenomyosis, 62 patients operated on for chronic abnormal uterine bleeding were examined. The control group consisted of 30 premenopausal patients who applied for preventive examination. Anthropometric and ultrasound examinations, assessment of carbohydrate and lipid metabolism, histologic examination were done. It has been established that uterine hyperplasia patients often had lipid metabolism damages (dislipidemy) and damages of carbohydrate one (alimentary – constitutional obesity, metabolic syndrome) which worsen the clinical course of the main disease. According to histological examination data, the activity of adenomyosis foci in patients with comorbid uterine pathology correlated with the severity of clinical manifestations (abnormal uterine bleeding, pain) and the presence of comorbid lesions (concomitant endometrial hyperplasia, chronic endometriosis, fibroids, endometriosis).
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Clinical and morphological features of combined hyperplastic diseases of the uterus against the background of adenomyosis DOI: https://doi.org/10.12775/JEHS.2020.10.04.025Keywords hyperplastic diseases of the uterus, adenomyosis, endometriosis, dislipidemy, metabolic syndromeAbstract To determine clinical and morphological features of combined uterine hyperplastic diseases in premenopausal women at the background of adenomyosis, 62 patients operated on for chronic abnormal uterine bleeding were examined. The control group consisted of 30 premenopausal patients who applied for preventive examination. Anthropometric and ultrasound examinations, assessment of carbohydrate and lipid metabolism, histologic examination were done. It has been established that uterine hyperplasia patients often had lipid metabolism damages (dislipidemy) and damages of carbohydrate one (alimentary – constitutional obesity, metabolic syndrome) which worsen the clinical course of the main disease. According to histological examination data, the activity of adenomyosis foci in patients with comorbid uterine pathology correlated with the severity of clinical manifestations (abnormal uterine bleeding, pain) and the presence of comorbid lesions (concomitant endometrial hyperplasia, chronic endometriosis, fibroids, endometriosis). References Nozari N. Screening and management of Metabolic Syndrome // Shiraz E-Medical Journal. 2011. Vol. 12. № 3. P. 144–149. Sidorenko AV Morphological features of adenomyosis in women of reproductive age who have combined pathology of the uterus / AV Sidorenko.// Odessa Medical Journal. - 2018. - №2. - P. 44 - 49. Goncharenko G. Yu. Clinical and morphological analysis of genital endometriosis./ G. Yu. Goncharenko.// Achievements of biology and medicine. - 2016.– №1 (27). - P. 57 - 60. Kunz G. Adenomyosis as a disorder of the early and late human reproductive period / G. Kunz, M. Herbertz, D. Beil // Reprod. Biomed. Online. - 2017. - Vol. 15. ¹6.-P. 681-685 Hamdan M. Influence of endometriosis on assisted reproductive technology outcomes: a systematic review and meta-analysis / M. Hamdan, S.Z. Omar, G. Dunselman // Obstet. Gynecol. - 2015. - Vol. 125. ¹ l.-P. 79-88. Healy D.L., Breheny S., Halliday J. et al. Prevalence and risk factors for obstetric haemorrhage in 6730 singleton births after assisted reproductive technology in Victoria Australia / D.L. Healy, S. Breheny, J. Halliday // Hum. Reprod.-2013.-Vol. 25. -¹ l.-P. 265- 274. Unified clinical protocol of primary, secondary (specialized) and tertiary (highly specialized) medical care. Tactics of management of patients with genital endometriosis. Approved by the Order of the Ministry of Health from 06.04.2016, №319 // Obstetrics. Gynecology. Genetics.-2016.-Vol.2, №2.-P.61-74. Damirov MM, Shabanov AM A new look at the pathogenesis of adenomyosis / MM Damirov.// Journal of NV Sklifosovsky Urgent medical care. - 2013. - №. 3.– P. 23 - 27 Kornatska AG Peculiarities of anatomical and functional state of pelvic organs and generative function in women with uterine leiomyoma / Kornatska AG, Kolesnichenko IS, Flaxemberg MA, Revenko OO // Women's health. - K., 2014. - № 10 (96). - P. 134–136 Yarotsky ME, Demyanenko LV, Doroga OP Peculiarities of benign uterine diseases in women of reproductive age with metabolic syndrome // Clinical Endocrinol and endocrine surgery.- 2016.- N 3.- C. 65-75 Anfinogenova Ye. A. Active and inactive adenomiosis: comparative analysis in foci of ectopic endometrium (expression of aromatize p-450, receptors of estrogenes alfa and beta, receptors of progesterone) // Herald of education and development of Russian academy of natural sciences.- 20116.- N 20.- P. 74 -82 Downloads Published How to Cite Issue Section License The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 Stats Number of views and downloads: 946 Number of citations: 0

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