An Update on the Various Theories of the Origin of Uterine Adenomyosis –A Systematic Review

Kulvinder Kochar Kaur, Gautam Allahbadia, Mandeep Singh
In: Archives of Urology · 2020 · vol. 3(1) , pp. 31–45 · doi:10.22259/2638-5228.0301004 · W3164911241
article OA: bronze CC0 ⤵ 2 in-corpus citations
🔓 Open OA copy View on OpenAlex View at publisher
⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This review examines theories of adenomyosis origin, including endometrial invagination and metaplasia, and proposes the new endometrial-myometrial interface disruption hypothesis linking it to iatrogenic trauma and hypoxia.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This systematic review updates multiple theories proposed for the origin of uterine adenomyosis by surveying existing literature on how the disease develops. Across included studies, the authors describe competing mechanistic explanations for adenomyosis pathogenesis, and they synthesize the overall state of evidence regarding these proposed origins. The main limitation is that the field remains heterogeneous, with varying study designs and levels of support for different theories, which prevents definitive conclusions about a single causal pathway. This paper is centrally about adenomyosis — it systematically reviews theories of adenomyosis origin.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Abstract

Adenomyosis is a frequently diagnosed estrogen based gynaecological disorder, whose pathology as well as etiology is not clear. For the origination of Adenomyotic lesions as well as modes implicated in the evolution as well as propagation of the disease, till now two basic theories had been posited like implication of tissue injury as well as repair mechanisms and promote that adenomyosis occurs via invagination of endometrium basalis in the myometrium. Another theory which says that Adenomyotic lesions occurs secondary to metaplasia of displaced embryonic pluripotent mullerian remnants or differentiation of adult stem cells. But as far as Guo's theory, both theories have apparent limitations, i.e., difficulty in falsification, explaining existing data, and making useful predictions. Based on the current understanding of wound healing, a new hypothesis, called endometrial-myometrial interface disruption (EMID), is proposed to account for adenomyosis resulting from iatrogenic trauma to EMI. The EMID hypothesis not only highlights the more salient feature, i.e., hypoxia, at the wounding site, but also incorporates epithelial mesenchymal transition, recruitment of bone-marrowderived stem cells, and enhanced survival and dissemination of endometrial cells dispersed and displaced due to iatrogenic procedures. More importantly, the EMID hypothesis predicts that the risk of adenomyosis can be reduced if certain perioperative interventions are performed. Consequently, from a pathogenic standpoint, adenomyosis is not simply endometriosis of the uterus, and, as such, may call for interventional procedures that are somewhat different from those for endometriosis to achieve the best results.

My notes (saved in your browser only)

Condition tags

endometriosisadenomyosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (49)

Cited by (2)

Source provenance

openalex
last seen: 2026-06-10T17:14:06.276822+00:00
License: CC0 · commercial use OK