Prevalence of Adenomyosis in Hysterectomy Specimens Performed at a Tertiary Hospital of Kathmandu, Nepal

Kricha Pande, S Koirala, Amrita Giri
In: Nepal Medical College Journal · 2020 · vol. 22(3) , pp. 118–122 · doi:10.3126/nmcj.v22i3.32629 · W3094971161
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A cross-sectional study of 154 hysterectomy specimens found adenomyosis in 24% of cases, most commonly in women aged 35-50, with leiomyoma being the frequent co-pathology.

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This cross-sectional study at Nepal Medical College and Teaching Hospital (Kathmandu) evaluated 154 hysterectomy specimens collected over one year (March 2019 to February 2020) to estimate the prevalence of adenomyosis and its association with other uterine pathology. Adenomyosis was found in 37 cases, yielding a prevalence of 24%, most commonly in women aged 36–52 years (mean 44 ± 4.4), and it was more frequent in the 35–50 age group. Among adenomyosis cases, the most frequent co-pathology was leiomyoma (19 cases), with fewer cases of endometriotic cyst (2), endometrial polyp (2), HSIL (1), endometrial hyperplasia with atypia (1), and serous cyst adenoma of the ovary (1). The paper does not state major methodological limitations, but it is based on specimens from a single tertiary hospital over a limited time period. This paper is centrally about adenomyosis—estimating its prevalence and co-occurrence with other uterine pathology in routine hysterectomy specimens.

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Abstract

Adenomyosis is a common condition, detected in 15-30% of hysterectomy specimens. It is characterized by the presence of endometrial glands and stroma within the myometrium. The data regarding incidence or incidental finding of adenomyosis in hysterectomy specimen is lacking despite this condition being common and bearing serious implications in symptomatology as well as in infertility. Adenomyosis can be incidental finding in hysterectomy done for other gynecologic pathology as well. Hence, this present study has established the prevalence of adenomyosis as well as it’s association with other uterine pathology in routine hysterectomy specimens. This was a cross sectional study conducted at Nepal Medical College and Teaching Hospital (NMCTH), Kathmandu for a duration of one year (March 2019 to February 2020). Total of 154 hysterectomies were included in the study, out of which 37 cases showed adenomyosis. The prevalence of adenomyosis was 24%. The age group for adenomyosis ranged from 36 years to 52 years with the mean age of 44 ± 4.4 years. The most common pathology other than adenomyosis was leiomyoma (19 cases) followed by two cases of endometriotic cyst, two cases of endometrial polyp, one case of high grade squamous intraepithelial lesion (HSIL), one case of hyperplasia of endometrium with atypia, and one case of serous cyst adenoma of ovary. Thus this study showed that the prevalence of adenomyosis was 24% and was seen higher in the age group of 35-50 years. The most frequent co-pathology in these adenomyosis cases was leiomyoma.
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Prevalence of Adenomyosis in Hysterectomy Specimens Performed at a Tertiary Hospital of Kathmandu, Nepal DOI: https://doi.org/10.3126/nmcj.v22i3.32629Keywords: Adenomyosis, hysterectomy, leiomyomaAbstract Adenomyosis is a common condition, detected in 15-30% of hysterectomy specimens. It is characterized by the presence of endometrial glands and stroma within the myometrium. The data regarding incidence or incidental finding of adenomyosis in hysterectomy specimen is lacking despite this condition being common and bearing serious implications in symptomatology as well as in infertility. Adenomyosis can be incidental finding in hysterectomy done for other gynecologic pathology as well. Hence, this present study has established the prevalence of adenomyosis as well as it’s association with other uterine pathology in routine hysterectomy specimens. This was a cross sectional study conducted at Nepal Medical College and Teaching Hospital (NMCTH), Kathmandu for a duration of one year (March 2019 to February 2020). Total of 154 hysterectomies were included in the study, out of which 37 cases showed adenomyosis. The prevalence of adenomyosis was 24%. The age group for adenomyosis ranged from 36 years to 52 years with the mean age of 44 ± 4.4 years. The most common pathology other than adenomyosis was leiomyoma (19 cases) followed by two cases of endometriotic cyst, two cases of endometrial polyp, one case of high grade squamous intraepithelial lesion (HSIL), one case of hyperplasia of endometrium with atypia, and one case of serous cyst adenoma of ovary. Thus this study showed that the prevalence of adenomyosis was 24% and was seen higher in the age group of 35-50 years. The most frequent co-pathology in these adenomyosis cases was leiomyoma. Downloads Downloads Published How to Cite Issue Section License This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format, so long as attribution is given to the creator. The license allows for commercial use.

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