Adenomyose

In: Journal für Gynäkologische Endokrinologie/Österreich · 2019 · vol. 29(3) , pp. 76–85 · doi:10.1007/s41974-019-00111-0 · W2980487205
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AI-generated summary by claude@2026-06+body, 2026-06-23

This review summarizes recent advancements in understanding adenomyosis pathogenesis, imaging diagnosis limitations and achievements, and conservative and surgical treatment options.

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This paper is a narrative overview of advances in understanding and diagnosing uterine adenomyosis over the last decade, covering proposed mechanisms of pathogenesis, the achievements and limitations of imaging (including ultrasound and MRI) for diagnosis, and both conservative and surgical treatment options. The author synthesizes prior literature rather than conducting original human or animal studies, and explicitly notes that no such studies were performed for the contribution. A key theme is that diagnostic and treatment approaches have improved, while imaging methods still have limitations that affect how adenomyosis is assessed. This paper is centrally about endometriosis and/or adenomyosis—specifically adenomyosis—by providing an overview of progress in its pathogenesis, imaging-based diagnosis, and treatment options.

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Zusammenfassung Relevante Fortschritte konnten in Hinblick auf Verständnis und Diagnose der Adenomyose im letzten Jahrzehnt erzielt werden. Der folgende Artikel stellt einen Überblick über Erkenntnisse in Pathogenese, Möglichkeiten und Grenzen der Bildgebung sowie konservative und chirurgische Behandlungsmöglichkeiten der Adenomyose vor. Abstract In the last decade, relevant progress could be achieved in understanding and diagnosing adenomyosis. The following article gives a comprehensive overview of pathogenesis, achievements and limitations in imaging techniques as well as the treatment options of adenomyosis. Similar content being viewed by others Literatur García-Solares J, Donnez J, Olivier Donnez, Dolmans M‑M (2018) Pathogenesis of uterine adenomyosis: invagination or metaplasia? Fertil Steril 109(3):371–379 Van den Bosch T, Dueholm M, Leone FP, Valentin L, Rasmussen CK, Votino A, Van Schoubroeck D, Landolfo C, Installé AJ, Guerriero S, Exacoustos C, Gordts S, Benacerraf B, D’Hooghe T, De Moor B, Brölmann H, Goldstein S, Epstein E, Bourne T, Timmerman D (2015) Terms, definitions and measurements to describe sonographic features of myometrium and uterine masses: a consensus opinion from the Morphological Uterus Sonographic Assessment (MUSA) group. Ultrasound Obstet Gynecol 46(3):284–298. https://doi.org/10.1002/uog.14806 Van den Bosch T, de Bruijn AM, de Leeuw RA, Dueholm M, Exacoustos C, Valentin L, Bourne T, Timmerman D, Huirne JAF (2019) Sonographic classification and reporting system for diagnosing adenomyosis. Ultrasound Obstet Gynecol 53(5):576–582. https://doi.org/10.1002/uog.19096 Bazot M, Daraï E (2018) Role of transvaginal sonography and magnetic resonance imaging in the diagnosis of uterine adenomyosis. Fertil Steril 109(3):389–397 Osada H (2018) Uterine adenomyosis and adenomyoma: the surgical approach. Fertil Steril. 109(3):406−417 Zaloudek C, Norris HJ (1987) Mesenchymal tumors of the uterus. In: Kurmann RJ (Hrsg) Blaunstein’s pathology of the female genital tract. 3. Aufl. Springer, New York Leyendecker G, Wildt L (2011) A new concept of endometriosis and adenomyosis: tissue injury and repair (TIAR). Horm Mol Biol Clin Investig. 5(2):125–142 Azziz R (1989) Adenomyosis: current perspectives. Obstet Gynecol Clin North Am. 16(1):221–235 Campo S, Campo V, Benagiano G (2012) Infertility and adenomyosis. Obstet Gynecol Int. 2012:786132. https://doi.org/10.1155/2012/786132 Younes G, Tulandi T (2017) Effects of adenomyosis on in vitro fertilization treatment outcomes: a meta-analysis. Fertil Steril. 108(3):483–490.e3 Lazzeri L, Di Giovanni A, Exacoustos C, Tosti C, Pinzauti S, Malzoni M, Petraglia F, Zupi E (2014) Preoperative and Postoperative Clinical and Transvaginal Ultrasound Findings of Adenomyosis in Patients With Deep Infiltrating Endometriosis. Reprod Sci. 21(8):1027–1033 Exacoustos C, Brienza L, Di Giovanni A, Szabolcs B, Romanini ME, Zupi E, Arduini D (2011) Adenomyosis: three-dimensional sonographic findings of the junctional zone and correlation with histology. Ultrasound Obstet Gynecol. 37(4):471–479 Luciano DE, Exacoustos C, Albrecht L, LaMonica R, Proffer A, Zupi E, Luciano AA (2013) Three-dimensional ultrasound in diagnosis of adenomyosis: histologic correlation with ultrasound targeted biopsies of the uterus. J Minim Invasive Gynecol. 20(6):803–810 Nam JH, Lyu GS (2015) Abdominal ultrasound-guided transvaginal myometrial core needle biopsy for the definitive diagnosis of suspected adenomyosis in 1032 patients: a retrospective study. J Minim Invasive Gynecol. 22(3):395–402. https://doi.org/10.1016/j.jmig.2014.08.006. Epub 2014 Aug 11 Gordts S, Grimbizis G, Campo R (2018) Symptoms and classification of uterine adenomyosis, including the place of hysteroscopy in diagnosis. Fertil Steril. 109(3):380–388.e1 Exacoustos C, Luciano D, Corbett B, De Felice G, Di Feliciantonio M, Luciano A, Zupi E (2013) The uterine junctional zone: a 3-dimensional ultrasound study of patients with endometriosis. Am J Obstet Gynecol. 209(3):248.e1–7 Sharma K, Bora MK, Venkatesh BP, Barman P, Roy SK, Jayagurunathan U, Sellamuthu E, Moidu F (2015) Role of 3D Ultrasound and Doppler in Differentiating Clinically Suspected Cases of Leiomyomaand Adenomyosis of Uterus.J Clin Diagn Res. 9(4):QC08–12. https://doi.org/10.7860/JCDR/2015/12240.5846. Epub 2015 Gordts S, Grimbizis G, Campo R (2018) Symptoms and classification of uterine adenomyosis, including the place of hysteroscopy in diagnosis. Fertil Steril. 109(3):380–388.e1 Krentel H et al (2017) From clinical symptoms to MR imaging: diagnostic steps in adenomyosis. Biomed Res Int 2017:1514029 Vannuccini S, Luisi S, Tosti C, Sorbi F, Petraglia F (2018) Role of medical therapy in the management of uterine adenomyosis. Fertil Steril. 109(3):398–405 Zhang L, Rao F, Setzen R (2017) High intensity focused ultrasound for the treatment of adenomyosis: selection criteria, efficacy, safety and fertility. Acta Obstet Gynecol Scand. 96(6):707–714 Lazzeri L, Morosetti G, Centini G, Monti G, Zupi E, Piccione E, Exacoustos C (2018) A sonographic classification of adenomyosis: interobserver reproducibility in the evaluation of type and degree of the myometrial involvement. Fertil Steril. 110(6):1154–1161.e3. https://doi.org/10.1016/j.fertnstert.2018.06.031 Rasmussen CK, Van den Bosch T, Exacoustos C, Manegold-Brauer G, Benacerraf BR, Froyman W, Landolfo C, Condorelli M, Egekvist AG, Josefsson H, Leone FPG, Jokubkiene L, Zannoni L, Epstein E, Installé A, Dueholm M (2019) Intra- and Inter-Rater Agreement Describing Myometrial Lesions Using Morphologic Uterus Sonographic Assessment: A Pilot Study. J Ultrasound Med. 38(10):2673–2683. https://doi.org/10.1002/jum.14971. Epub 2019 Feb 23 Author information Authors and Affiliations Corresponding author Ethics declarations Interessenkonflikt E. Janschek gibt an, dass kein Interessenkonflikt besteht. Für diesen Beitrag wurden von der Autorin keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. Additional information Hinweis des Verlags Der Verlag bleibt in Hinblick auf geografische Zuordnungen und Gebietsbezeichnungen in veröffentlichten Karten und Institutsadressen neutral. Rights and permissions About this article Cite this article Janschek, E. Adenomyose. J. Gynäkol. Endokrinol. AT 29, 76–85 (2019). https://doi.org/10.1007/s41974-019-00111-0 Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s41974-019-00111-0

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