Laparoscopic uterine biopsy for diagnosing diffuse adenomyosis.

P Vercellini, Vercellini P, Paolo Vercellini, Laura Trespìdi, L Trespidi, Trespidi L, Stefania Panazza, S Panazza, Panazza S, Bramante T, T Bramante, Tiziana Bramante, Mauro F, F Mauro, Fabio Mauro, Crosignani PG, Pier Giorgio Crosignani, P. G. Crosignani
The Journal of reproductive medicine · 1996 · vol. 41(4) , pp. 220–4 · PMID:8728071 · W2075323048
article OA: closed CC0 ⤵ 22 in-corpus citations
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Laparoscopic uterine needle biopsy safely diagnosed adenomyosis in 19% of women with menstrual pain and 17% of asymptomatic women, with endometriosis more frequent and severe in painful subjects.

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Abstract

OBJECTIVE: To investigate the possibility of diagnosing diffuse adenomyosis with the uterus in situ. STUDY DESIGN: Myometrial needle biopsy was performed on a prospectively evaluated series of 72 women undergoing laparoscopy for infertility and/or chronic pelvic pain. Before surgery the patients completed a questionnaire on the presence and severity of dysmenorrhea according to a linear analog and verbal rating scale. A single specimen was taken from along the median line in the upper third of the posterior uterine wall using a 14-gauge Tru-cut needle inserted through the anterior abdominal wall under laparoscopic guidance. RESULTS: No complications occurred. Adenomyosis was diagnosed in 8 of the 42 subjects with menstrual pain and 5 of the 30 asymptomatic ones (19% versus 17%) and pelvic endometriosis in 27 and 10, respectively (64% versus 33%, P = .02). The frequency of moderate or severe dysmenorrhea was greater in women with adenomyosis than in those without adenomyosis or endometriosis, but the difference was not statistically significant. Conversely, menstrual pain was significantly more frequent and severe in patients with endometriosis as compared with women who had neither endometriosis nor adenomyosis. CONCLUSION: Uterine needle biopsy is simple, rapid and safe, but its overall clinical importance, as well as the predictive value of a normal histologic result, requires further investigation.

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Condition tags

dysmenorrheaendometriosisadenomyosischronic_pelvic_paininfertility

MeSH descriptors

Biopsy, Needle Endometriosis Laparoscopy Myometrium Adult Biopsy, Needle Biopsy, Needle Dysmenorrhea Dysmenorrhea Dysmenorrhea Endometriosis Endometriosis Endometriosis Female Humans Incidence Laparoscopes Laparoscopy Linear Models Myometrium

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