Original Article ADENOMYOSIS UTERI IN INFERTILE WOMEN: EXPERIENCE IN A TROPICAL COMMUNITY TEACHING HOSPITAL

Objectives: To determine the demographic pattern and clinical presentation of 23 infertile women with intraoperative diagnosis of adenomyosis followed by histopathologic confirmation. Methodology: A review of 23 consecutive infertile women that underwent surgery due to preoperative misdiagnosis for uterine fibroids over a period of 5 years. Results: The patients mean age was 37.3 years with age range of 26 to 47 years. Only five patients (21.7%) had delivered before. Eighteen patients (78.3%) had had abortion(s) in the past. Secondary infertility accounted for 78.3 % and 21.7 % had primary infertility. Past gynaecological procedures included dilatation and curettage or manual vacuum aspiration in 17 (73.9%) patients, previous adhesiolysis for uterine synaechiae in 3 (13.1%) patients and past history of myomectomy in 5 (21.7%) patients. Preoperative hysterosalpingogram showed only 2 patients (8.7%) with bilateral tubal patency and 17 patients (73.9%) had bilateral tubal blockage. Unilateral patency of the fallopian tube was observed in 4 (17.4%) patients. Amongst patients with bilateral tubal blockage, cornual blockages were mostly encountered in 15 (88.2%) of the 17 patients. The modes of clinical presentation were abdominopelvic mass 100%, dymenorrhoea 82.6%, menorrhagia 60.9%, dyspareunia 47.8 % and metrorrhagia in 34.8 % of cases.