Adénomyose

Résumé La définition est histologique. L’implant endométrial doit se situer à plus de 2 mm de la jonction endomètre-myomètre. La théorie de Cullen reste encore d’actualité. Le tableau clinique évocateur (ménorragie dysménorrhée, gros utérus) ne se retrouve que chez 18 % des cas, car l’association avec d’autres pathologies utérines bénignes est habituelle. L’échographie pelvienne et endovaginale ont une sensibilité et une spécificité variable suivant les séries rapportées. En ce qui concerne l’IRM, la sensibilité et la spécificité sont de 70 et 90 %. L’hystérographie met en évidence des images d’addition ou de rigidité segmentaire. Cette exploration est actuellement délaissée au profit de l’hystéroscopie qui met en évidence les orifices diverticulaires et les noyaux d’adénomyose lorsque ceux-ci sont situés à proximité de la cavité utérine. L’IRM reste cependant l’exploration la plus pertinente pour cette pathologie. Le traitement médical est efficace, mais les effets secondaires sont importants (analogues du LH-RH, danazol). L’endométrectomie permet d’éviter un geste chirurgical agressif, elle est efficace si les implants endométriosiques sont à moins de 4 mm de la cavité utérine. L’hystérectomie est indiquée en cas d’échec des traitements antérieurs et en présence de formes diffuses et profondes symptomatiques. Preview Unable to display preview. Download preview PDF. Références Troiano RN, Stuart SD, Mc Carthy S (1998) Cystic adenomyosis of the uterus: MRI. J Magn Reson Imaging 8: 1198–202 Bergeron C (1993) Adénomyose: de l’histologie aux récepteurs des stéroïdes. Gynécologie Internationale 2: 277–9 Novak E, Woodruff JD (1974) Adenomyosis uteri. Gynecologic and Obstetric pathology. 7e edition, 261 De Brux J (1982). Histopathologie gynécologique. 2e édition, Masson Azziz R (1989) Adenomyosis: current perspectives. Obstet Gynecol Clin N Am 16: 221–35 Ferenczy A (1998) Pathophysiology of adenomyosis. Hum Reprod Update 4: 312–22 Cullen TS (1920) Adenomyoma of uterus. Arch Surg: 215 Canis M, Mage G, Pouly JL et al. (1999) Adénomyose. Encycl Med Chir Gynécologie 150 A 20.3.5 p Quereux C, Alègre M, Dorangeon (1991) Adénomyose: une entité méconnue, un diagnostic possible à propos de 91 cas. J Gynecol Obstet Biol Reprod 2: 20284.95 Delarue T, Baty A, Foissey A (1988) Ménorragies, métrorragies et endomètre. À propos de 300 cas. J Gynecol Obstet Biol Reprod 17: 57, 64 Vavilis D, Agorastos T, Tzafetas J et al. (1997) Adenomyosis at hysterectomy: prevalence and relationship to operative findings and reproductive and menstrual factors. Clin Exp Obstet Gynecol 24(1): 36–8 Cohen I, Beyth Y, Shapira J et al. (1997) High frequency of adenomyosis in postmenopausal breast cancer patients treated with tamoxifen. Gynecol Obstet Invest 44(3): 200–5 Siedler D, Laing FC, Jeffrey RB Jr et al. (1987) Uterine adenomyosis. A difficult sonographic diagnosis. J Ultrasound Med 6: 345–9 Bazot M, Cortez A, Darai E et al. (2001) Ultrasonography compared with magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology. Hum Reprod 16: 2427–33 Reinhold C, Atri M, Mehio A et al. (1995) Diffuse uterine adenomyosis: morphologic criteria and diagnostic accuracy of endovaginal sonography. Radiology 197: 609–14 Bromley B, Shipp TD, Benacerraf B (2000) Adenomyosis: sonographic findings and diagnostic accuracy. J Ultrasound Med 19: 529–34 Dueholm M, Lundorf E, Hansen ES et al. (2001) Magnetic resonance imaging and transvaginal ultrasonography for the diagnosis of adenomyosis. Fertil Steril 76: 588–94 Atri M, Reinhold C, Mehio AR et al. (2000) US features with histologic correlation in an in-vitro study. Radiology 215: 783–90 Reinhold C, McCarthy S, Bret PM et al. (1996) Diffuse adenomyosis: comparison of endovaginal US and MR imaging with histopathologic correlation. Radiology 199: 151–8 Togashi K, Nishimura K, Itoh K et al. (1988) Adenomyosis: diagnosis with MR imaging. Radiology 166: 111–4 Dueholm M, Lundorf E, Sorensen JS et al. (2002) Reproducibility of evaluation of the uterus by transvaginal sonography, hysterosonographic examination, hysteroscopy and magnetic resonance imaging. Hum Reprod 17: 195–200 Blanc B, Boubli L (1996) Endoscopie utérine. Pradel Ed. Paris, 153–61 Mark AS, Hricak H, Heinrichs LW et al. (1987) Adenomyosis and leiomyoma: differential diagnosis with MR imaging. Radiology 163: 527–9 Togashi K, Ozasa H, Konishi I et al. (1989) Enlarged uterus: differentiation between adenomyosis and leiomyoma with MR imaging. Radiology 171: 531–4 Wood C (1998) Surgical and medical treatment of adenomyosis. Hum Reprod Update 4 no4: 323–36 Mc Causlan V, Mc Causlan A. (1998). The response of adenomyosis to endometrial ablation resection Chang CS, Shiao CH (2002) Assessment of effects of medical treatment prior or after conservative surgery for patients with adenomyosis-preliminary report. Fertility Sterility. Abstracts 77:2.S54 Igarashi M, Iizuka M, Ahe Y et al. (1996) A new therapy for uterine adenomyosis. Vth Worl congress on Endometriosis 21–24 October, Yokohama, Japan Abstract 0–155 p 80 Tanaoka Y, Yamamoto Y et al. (1996) Investigation of treatment of adenomyosis by intra-uterine device that contains danazol. Vth Worl congress on Endometriosis 21–24 October, Yokohama, Japan Abstract 0–155 p 80 Brosens JJ, Briherstaff H, De Souza NM (1996). Intrauterine Danazol vs Goserelin for treatment of uterine adenomyosis a pilot study Vth Worl congress on Endometriosis 21–24 October, Yokohama, Japan Abstract 0–157 p 81 Goldfard HA (1990) A review of 35 endometrial ablations using the ND: YAG laser for menometrorragia. Obstet Gynecol 76: 833–5 Goldrath MH (1992) Neodynium YAG laser Hysteroscopy: total endometrial ablation. In: Sutton C. Lasers in Gynecology Chapman and Hall, London, p 175–81 Raiga et al. (1994) Failure factors in endometrial resection. J Gynecol Obstet Biol Reprod 23: 274–8 Mergui JL, Solidakis A, Salat Baroux (1997) Contracept Fert Sex 25.2.105.111 Gimpelson JR, Kaigh J (1992) Endometrial ablation. repeat procedures. Cases studies. J Reprod Med: 629–35 Gannon JM, Holt ME, Fairbank J et al. (1991) A randomised trial comparing endometrial resection and abdominal hysterectomy for treatment of menorraghia. Br Med J 3031362.1364 Smith SJ, Sewall LE, Handelsman A (1999) A clinical failure of uterin fibroid embolization due to adenomyosis. J Vascu Interv Radiol oct 10(9): 1171.4 Siskin GP, Tublin ME, Stainken BF et al. (2001) Uterine artery embolization for the treatment of adenomyosis: clinical response and evaluation with MR imaging. AJR Am J Roentgenol Aug 177(2): 297–302 Author information Authors and Affiliations Rights and permissions Copyright information © 2005 Springer-Verlag France About this chapter Cite this chapter Orazi, G., Cosson, M., Robert, Y. (2005). Adénomyose. In: Pelvi-périnéologie. Springer, Paris. https://doi.org/10.1007/2-287-27807-9_50 Download citation DOI: https://doi.org/10.1007/2-287-27807-9_50 Publisher Name: Springer, Paris Print ISBN: 978-2-287-00501-5 Online ISBN: 978-2-287-27807-5 eBook Packages: MedicineMedicine (R0)