Diagnosis and treatment of uterine adenomyosis: an analysis of 318 cases

Objective To investigate the incidence, clinical characteristics, diagnosis and treatment of uterine ade-nomyosis.Methods Clinical data of 318 patients with adenomyosis confirmed by pathology from January 1997 to December 1999 admitted in our gynecological ward were analyzed retrospectively. Results The incidence of adenomyosis was 5.7% of total gynecological hospitalized patients and accounted for 20.9% among all patients hysterectomy.217/318 (68.2%) cases had dysmenor-rhea and 132 (41.5%) had menorrhagia.A hundred and ninety-two cases were diagnosed as adenomyosis preoperatively, with 60.4% diagnostic accuracy. The serum CA-125 was positive in 72.3% of patients measured. All except two patients were treated with hysterectomy. Before operation, 33 patients had received hormone treatment, e.g.gestrinone, danazol, mifepristone, estrogen, progestins or androgen, for more than three months.Dysmenorrhea was relieved in 80.0% of patients during the hormone medicine treatment, but symptoms recurred in 75.0% of cases at the first menstrual cycle after the cessation of treatment. Conclusions Hysterectomy remains the dominant treatment of adenomyosis up to now. Drugs effective for treatment of endometriosis were also effective for relief of dysmenorrhea to patients with uterine adenomyosis although the dysmenorrhea recurred rapidly when medical treatment was stopped.