Occurrence of adenomyosis, adenomyoma, and myohyperplasia in women undergoing hysterectomy for leiomyoma (AUB-L): A cross-sectional study

Objective: To evaluate the occurrence of adenomyosis, adenomyoma, and myohyperplasia in women undergoing hysterectomy for leiomyoma (AUB-L), and to correlate these findings with preoperative clinical diagnoses and imaging modalities.Methods: A cross-sectional study was conducted at the Department of Obstetrics and Gynecology at Gauhati Medical College and Hospital, Assam, India. Two hundred women who underwent hysterectomy for abnormal uterine bleeding associated with leiomyoma were included. Patients were evaluated for adenomyosis and allied myometrial pathologies using histopathological examination, with specific attention given to demographic parameters, presenting complaints, and imaging findings.Results: Of the women studied, the peak prevalence of adenomyosis was observed within the 40–49 year age group (80.5%), followed by cases of leiomyoma (60.5%). Histopathological examination revealed adenomyosis in 37% (74 patients), adenomyoma in 2% (4 patients), and myohyperplasia in only 0.5% (1 patient). Despite the high prevalence of menorrhagia (56.5%) among patients, no significant association with histopathological findings was found (p=0.77). MRI proved to be significantly more accurate than ultrasound in diagnosing adenomyosis.Conclusion: Our study highlights the substantial occurrence of adenomyosis, adenomyoma, and myohyperplasia in women undergoing hysterectomy for leiomyoma. It demonstrates that conventional imaging modalities (such as ultrasound) inadequately diagnose these conditions compared to MRI, highlighting the need for robust preoperative assessment to improve clinical outcomes and guide therapeutic decisions.