Adenomyosis and HIFU Ablation

In: Focused Ultrasound Surgery in Gynecology · 2021 · pp. 63–70 · doi:10.1007/978-981-16-0939-8_5 · W3147892575
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This paper introduces adenomyosis as a condition involving endometrial tissue in the uterine myometrium, impacting women of reproductive age and leading to symptoms like dysmenorrhea and infertility.

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This chapter reviews adenomyosis—defined as endometrial glands invading the uterine myometrium with surrounding muscle hyperplasia and hypertrophy—covering epidemiology, symptom patterns, and proposed pathogenesis, including the hypothesis that intrauterine manipulations may damage the basal endometrium and promote invasion. It reports that adenomyosis occurs most often in women aged 30–50, estimates prevalence around 20–30% in reproductive-aged women (varying by population), and notes that many patients are asymptomatic while others have pelvic endometriosis or coexisting fibroids. The chapter also describes clinical impacts such as dysmenorrhea, increased menstrual flow, infertility, and overall effects on physical and mental health, with a stated limitation that the pathogenesis remains unknown. This paper is centrally about endometriosis and adenomyosis—specifically adenomyosis and its management in the context of focused ultrasound ablation (HIFU).

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Abstract

Adenomyosis is due to the invasion or presence of endometrial glands in the uterine myometrium accompanied by hyperplasia and hypertrophy of the surrounding muscle cells, forming diffuse or focal lesions. Adenomyosis occurs most often in women between the ages of 30 and 50, but it can also be in younger women who have not had children. The incidence of adenomyosis is about 20–30% of reproductive-aged women, but this varies according to the particular population [1]. Recently, there appears to have a significant increase in the incidence and younger age patients. Thirty-five percent of patients are without symptoms, 15–30% associated with pelvic endometriosis, and 50% with uterine fibroids. The pathogenesis of adenomyosis is unknown, but in some patients, there is a belief that any intrauterine manipulations such as surgical termination of pregnancy can damage the endometrium’s basal layer, causing the endometrial gland to invade into the myometrium thus increasing the extent and severity of adenomyosis. Adenomyosis can then lead to dysmenorrhea and increased menstrual flow, infertility, and other related symptoms [2]. This disease seriously affects women’s physical and mental health. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

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adenomyosis

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