A critical review of recent advances in the diagnosis, classification, and management of uterine adenomyosis

Justin Tan, Paul J. Yong, Paul Yong, Mohamed A Bedaiwy
Current opinion in obstetrics & gynecology · 2019 · vol. 31(4) , pp. 212–221 · doi:10.1097/gco.0000000000000555 · PMID:31192829 · W2952278004
review OA: closed CC0 ⤵ 30 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This review highlights recent advances in adenomyosis diagnosis, including imaging correlations with pathogenesis, updated classification systems, and promising medical and surgical management strategies for pelvic pain and bleeding.

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Abstract

PURPOSE OF REVIEW: The purpose of this review is to summarize and highlight recent critical advances in the diagnosis, classification, and management of adenomyosis. RECENT FINDINGS: Recent studies have clarified the specific mechanism through which adenomyotic lesions invade the underlying myometrium by epithelial-mesenchymal transition. Correlation studies using diagnostic MRI also strongly support the hypothesis of a different pathogenesis between the inner and outer myometrium forms of adenomyosis. Given advances in diagnostic imaging, several international organizations have also highlighted the importance of classification systems for adenomyosis. Finally, selective progesterone receptor modulators and gonadotropin-releasing hormone antagonists have demonstrated significant promise for treating pelvic pain and bleeding associated with adenomyosis, whereas novel fertility-preserving surgical techniques have been introduced to excise diffuse adenomyotic pathology while maintaining adequate uterine integrity. SUMMARY: Recent attempts at a uniform and reproducible classification system likely represent the first step for the development of a staging system for adenomyosis that can be correlated with the severity of clinical symptoms and promote an individualized therapeutic approach. Simultaneously, further insights into the etiology and pathogenesis as outlined in this review may also help in the development of targeted medical therapies.

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Condition tags

mesh:D017699adenomyosis

MeSH descriptors

Adenomyosis Adenomyosis Adenomyosis Adenomyosis Animals Female Fertility Preservation Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone Hormones Hormones Humans Pelvic Pain Pelvic Pain Receptors, Progesterone Receptors, Progesterone Ultrasonography Uterus Uterus

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.

References (100)

Cited by (30)

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License: CC0 · commercial use OK