Adenomyosis at Hysterectomy: Prevalence, Patient Characteristics, Clinical Profile and Histopatholgical Findings

Anju Shrestha, A Shrestha, Shrestha A, Rubina Shrestha, R Shrestha, Shrestha R, LB Sedhai, Sedhai LB, L B Sedhai, Upendra Pandit, Pandit U, U Pandit
Kathmandu University medical journal (KUMJ) · 2012 · vol. 10(1) , pp. 44–47 · doi:10.3126/kumj.v10i1.6915 · PMID:22971863 · W2139155316
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⚙ AI-generated summary by claude@2026-06, 2026-06-13 ⓘ

This study found adenomyosis in 23.4% of hysterectomy specimens, with menorrhagia, dysmenorrhea, and lower abdominal pain presenting most frequently in affected women.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

This study examined the prevalence and clinical profile of adenomyosis in hysterectomy specimens, enrolling 60 women with histopathologically proven adenomyosis treated between April 2009 and March 2010, and reviewing symptom, exam, laboratory, and gross/histopathological findings. Among 256 women scheduled for hysterectomy, adenomyosis was diagnosed in 23.4% of cases, with menorrhagia (91.2%), dysmenorrhea (84.2%), and lower abdominal pain (84.2%) reported as classic features, and symptoms beginning later in reproductive life (mean age ~45). Adenomyosis co-occurred in varying proportions across surgical indications, including notably 75% among those with endometriosis, and the authors focused on correlating clinical examination with histopathology. The study was limited by its inclusion of only hysterectomy patients and by lack of preoperative diagnostic confirmation beyond the setting described, meaning adenomyosis could not be assessed outside this surgical population. This paper is centrally about adenomyosis—its prevalence, patient characteristics, clinical profile, and histopathological findings at hysterectomy, with specific co-occurrence data reported for endometriosis.

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Abstract

BACKGROUND: Underlying adenomyosis is often the cause of treatment failure for patients undergoing medical therapy for abnormal uterine bleeding and or chronic pelvic pain. Given the limitation of ultrasonography in diagnosing adenomyosis and MRI being unaffordable to most of the patients belonging to developing countries like us, it often remains undiagnosed before a hysterectomy. OBJECTIVE: To find out the clinical profile associated with adenomyosis and to determine the prevalence of adenomyosis in hysterectomy specimens; frequency distribution, as well as to correlate clinical examination with histopathological examination. METHODS: A total of 60 women who had undergone hysterectomy with histopathologically proven adenomyosis between April 2009 and March 2010 were included . Data were collected on indication for the intervention, age, symptoms, clinical findings, hemoglobin, menopausal status, gross and histopathological findings. RESULTS: A total of 256 women were scheduled for hysterectomy. Adenomyosis was diagnosed in 60 of 256 cases (23.4%). Menorrhagia (91.2%), dysmenorrhoea (84.2%), lower abdominal pain (84.2%) beginning later in reproductive life (mean age- 45yrs) is the classic presentation. Adenomyosis was present in 10 of 61 patients (16.3%) with fibroids; 27 of 60 (45%) with abnormal uterine bleeding; 11 of 55 (20%) with prolapse; four of 35 (11.4%) with ovarian mass; five of 25 (20%) with chronic pelvic pain; three of four (75%) with endometriosis. CONCLUSION: Women undergoing hysterectomy with diagnosis of adenomyosis have a distinct symptomatology. The choice of therapy in adenomyosis is hysterectomy for those women who have completed family and had failed medical therapy .
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Background

Underlying adenomyosis is often the cause of treatment failure for patients undergoing medical therapy for abnormal uterine bleeding and or chronic pelvic pain. Given the limitation of ultrasonography in diagnosing adenomyosis and MRI being unaffordable to most of the patients belonging to developing countries like us, it often remains undiagnosed before a hysterectomy.

Objective

To find out the clinical profile associated with adenomyosis and to determine the prevalence of adenomyosis in hysterectomy specimens; frequency distribution, as well as to correlate clinical examination with histopathological examination.

Methods

A total of 60 women who had undergone hysterectomy with histopathologically proven adenomyosis between April 2009 and March 2010 were included . Data were collected on indication for the intervention, age, symptoms, clinical findings, hemoglobin, menopausal status, gross and histopathological findings.

Results

A total of 256 women were scheduled for hysterectomy. Adenomyosis was diagnosed in 60 of 256 cases (23.4%). Menorrhagia (91.2%), dysmenorrhoea (84.2%), lower abdominal pain (84.2%) beginning later in reproductive life (mean age- 45yrs) is the classic presentation. Adenomyosis was present in 10 of 61 patients (16.3%) with fibroids; 27 of 60 (45%) with abnormal uterine bleeding; 11 of 55 (20%) with prolapse; four of 35 (11.4%) with ovarian mass; five of 25 (20%) with chronic pelvic pain; three of four (75%) with endometriosis.

Conclusion

Women undergoing hysterectomy with diagnosis of adenomyosis have a distinct symptomatology. The choice of therapy in adenomyosis is hysterectomy for those women who have completed family and had failed medical therapy . KATHMANDU UNIVERSITY MEDICAL JOURNAL VOL.10 | NO. 1 | ISSUE 37 | JAN - MAR 2012 | 53-56 DOI: http://dx.doi.org/10.3126/kumj.v10i1.6915

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Condition tags

endometriosisadenomyosischronic_pelvic_paindysmenorrhea

MeSH descriptors

Adenomyosis Adenomyosis Hysterectomy Adenomyosis Adult Aged Age Factors Cross-Sectional Studies Female Humans Hysterectomy Middle Aged Prevalence

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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