C-section induced adenomyosis, histopathological study of 429 cases of abdominal hysterectomy

Jaafar Makki, Ali M. Al-Shakarchi, Arkan Shubber Alhamdany
In: Journal of Endometriosis and Pelvic Pain Disorders · 2026 · doi:10.1177/22840265261468456 · W7172097988
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⚙ AI-generated summary by claude@2026-08, 2026-08-03 ⓘ

This histopathological study of 429 hysterectomy cases found a significant association between cesarean sections and the development of adenomyosis, with an odds ratio of 1.5.

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Abstract

Objectives: To evaluate the correlation between cesarean delivery and subsequent development of adenomyosis, to be diagnosed by histopathological study of hysterectomy cases. Methods: A retrospective study of 429 patients whom underwent a hysterectomy for a variety of benign and malignant conditions of female genital system, at Hilla teaching hospital where the study was carried out. A comprehensive review of clinical presentation and the pathology reports for those patients was recorded. In addition to check over any previous history of cesarean delivery. All the data of this case-control study are computed, analyzed, and calculated an odds ratio. Results: The results of this study has shown 96 (22.3%) cases of adenomyosis out of 429 total cases which included in this study. 53 patients or (55.2%) out of 96 patients were found to have adenomyosis only, the remaining cases were associated with leiomyoma (28\96 or 29.1%) and other gynecological disorders. Of those 96 patients founded to have adenomyosis, 55 (57.3%) had a history of cesarean sections, out of the total number of 165 C-section performed. Forty-one patients (42.7%) with normal vaginal delivery who had never undergone C-section showed histopathological features of adenomyosis. Conclusion: There were statistical evidences proved the significant association between the C-section & subsequent development of adenomyosis. The computed odds ratio was 1.5, reflect significant association between our variables.

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