Adenomyosis and Fibroids

In: Managing Ultrasonography in Human Reproduction · 2016 · pp. 77–88 · doi:10.1007/978-3-319-41037-1_5 · W2527872303
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Adenomyosis and fibroids are common myometrial lesions that can affect fertility and pregnancy, with standardized sonographic features described by the MUSA group.

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This paper reviews adenomyosis and uterine fibroids as two of the most common myometrial lesions, describing how fibroids are well-defined myometrial masses while adenomyosis is endometrial tissue within the myometrium. It summarizes how both conditions can affect fertility and pregnancy outcomes through impaired myometrial contractility and vascularization and via effects on implantation and placentation, and notes that sonographic features of myometrial masses have been standardized by the 2015 MUSA consensus group. A major limitation is that the chapter is a narrative description rather than an original study with new empirical results. This paper is centrally about endometriosis-adjacent pathology—specifically adenomyosis (endometrial tissue in the myometrium) and how it relates to fertility and pregnancy outcomes.

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Abstract

Adenomyosis and fibroids are the two most common myometrial lesions. Fibroids or leiomyomas are usually well-defined lesions consisting of myometrial tissue, while adenomyosis is defined as endometrial tissue within the myometrium (Figs. 5.1 and 5.2). Both lesions may affect fertility and pregnancy outcome by impairing myometrial contractility and vascularization or by interfering with implantation and placentation. Sonographic features of myometrial masses have been standardized in a consensus paper published in 2015 entitled “Terms, definitions and measurements to describe sonographic features of myometrium and uterine masses: a consensus opinion from the Morphological Uterus Sonographic Assessment (MUSA) group” [1]. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

Van den Bosch T, Dueholm M, Leone FPG, Valentin L, Rasmussen CK, Votino A, Van Schoubroeck D, Landolfo C, Installé AJF, Guerriero S, Exacoustos C, Gordts S, Benacerraf B, D’Hooghe T, De Moor B, Brölmann H, Goldstein S, Epstein E, Bourne T, Timmerman D. 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. 2015;46:284–98. Munro MG, Critchley HO, Broder MS, Fraser IS. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynaecol Obstet. 2011;113:3–13. Dueholm M. Transvaginal ultrasound for diagnosis of adenomyosis: a review. Best Pract Res Clin Obstet Gynaecol. 2006;20:569–82. Van Schoubroeck D, Van den Bosch T, Timmerman D. 3D ultrasound. In: Grimbizis GF, et al., editors. Female genital tract congenital malformations: classification, diagnosis and management. doi:10.1007/978-1-4471-5146-3_7. London: Springer; 2015. p. 79–98. Exacoustos C, Brienza L, Di GA, Szabolcs B, Romanini ME, Zupi E, Arduini D. Adenomyosis: three-dimensional sonographic findings of the junctional zone and correlation with histology. Ultrasound Obstet Gynecol. 2011;37:471–9. Votino A, Van den Bosch T, Installé A, Van Schoubroeck D, Kaijser J, Kacem Y, De Moor B, Van Pachterbeke C, Timmerman D. Optimizing the ultrasound visualization of the endometrial-myometrial junction (EMJ). Facts Views Vis Obgyn. 2015;7(1):60–3. Van den Bosch T, Votino A, Cornelis A, Vandermeulen L, Van Pachterbeke C, Van Schoubroeck D, Timmerman D. Optimizing the histological diagnosis of adenomyosis using in vitro three dimensional (3D) ultrasonography. Gynecol Obstet Invest. 2016. doi:10.1159/000445072. Amant F, Van den Bosch T, Vergote I, Timmerman D. Morcellation of uterine leiomyomas: a plea for patient triage. Lancet Oncol. 2015;16:1454–6. Brölmann H, Tanos V, Grimbizis G, Ind T, Philips K, van den Bosch T, Sawalhe S, van den Haak L, Jansen FW, Pijnenborg J, Taran FA, Brucker S, Wattiez A, Campo R, O'Donovan P, de Wilde RL, European Society of Gynaecological Endoscopy (ESGE) steering committee on fibroid morcellation. Options on fibroid morcellation: a literature review. Gynecol Surg. 2015;12:3–15. Van den Bosch T, Coosemans A, Morina M, Timmerman D, Amant F. Screening for uterine tumours. Best Pract Res Clin Obstet Gynaecol. 2012;26:257–66. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2017 Springer International Publishing Switzerland About this chapter Cite this chapter Van den Bosch, T. (2017). Adenomyosis and Fibroids. In: Guerriero, S., Martins, W., Alcazar, J. (eds) Managing Ultrasonography in Human Reproduction. Springer, Cham. https://doi.org/10.1007/978-3-319-41037-1_5 Download citation DOI: https://doi.org/10.1007/978-3-319-41037-1_5 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-319-41035-7 Online ISBN: 978-3-319-41037-1 eBook Packages: MedicineMedicine (R0)

Keywords

- Pulse Repetition Frequency - Peak Systolic Velocity - Junctional Zone - Sonographic Feature - Ultrasound Feature These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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adenomyosis

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