Adenomyosis: a frequent cause of abnormal uterine bleeding

Objectives: To determine if there are identifying characteristics or risk factors associated with adenomyosis and to determine if routine ultrasonography identifies patients at risk for adenomyosis. Methods: A retrospective cross-sectional study was conducted of 182 premenopausal women undergoing hysterectomy for benign conditions from January 1, 1997, to December 31, 1998. The standard technique for the pathologic evaluation of the uterus (three sections) was used. No additional microscopic sections were obtained. Results: Sixty-four of 182 uterine specimens had adenomyosis discovered on routine histologic inspection (35.2%). Those with adenomyosis were 25–52 years old. Seventy-two percent of the women complained of menorrhagia. However, there were no significant differences in the characteristics or risk factors in women with adenomyosis and those without. Ultrasonography had a sensitivity of 10% and a specificity of 100% in women suspected of having adenomyosis. Conclusions: The incidence of adenomyosis at our institution was higher than that reported previously. Whereas menorrhagia was the primary complaint in 72% of women with adenomyosis, we were unable to identify clinical or radiologic characteristics or risk factors unique to adenomyosis. Routine ultrasound examination was not sensitive in predicting adenomyosis.