Publication: Adenomyosis at Hysterectomy: Prevalence, Patient Characteristics, Clinical Profile and Histopatholgical Findings
Date
2012
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Underlying adenomyosis is often the cause of treatment failure for patients
undergoing medical therapy for abnormal uterine bleeding and or chronic pelvic
pain. Given the limitation of ultrasonography in diagnosing adenomyosis and MRI
being unaffordable to most of the patients belonging to developing countries like
us, it often remains undiagnosed before a hysterectomy.
Objective
To find out the clinical profile associated with adenomyosis and to determine the
prevalence of adenomyosis in hysterectomy specimens; frequency distribution, as
well as to correlate clinical examination with histopathological examination.
Methods
A total of 60 women who had undergone hysterectomy with histopathologically
proven adenomyosis between April 2009 and March 2010 were included . Data
were collected on indication for the intervention, age, symptoms, clinical findings,
hemoglobin, menopausal status, gross and histopathological findings.
Results
A total of 256 women were scheduled for hysterectomy. Adenomyosis was
diagnosed in 60 of 256 cases (23.4%). Menorrhagia (91.2%), dysmenorrhoea
(84.2%), lower abdominal pain (84.2%) beginning later in reproductive life (mean
age- 45yrs) is the classic presentation. Adenomyosis was present in 10 of 61
patients (16.3%) with fibroids; 27 of 60 (45%) with abnormal uterine bleeding; 11
of 55 (20%) with prolapse; four of 35 (11.4%) with ovarian mass; five of 25 (20%)
with chronic pelvic pain; three of four (75%) with endometriosis.
Conclusion
Women undergoing hysterectomy with diagnosis of adenomyosis have a distinct
symptomatology. The choice of therapy in adenomyosis is hysterectomy for those
women who have completed family and had failed medical therapy .
KEY WORDS
adenomyosis, hysterectomy, prevalence
Description
Shrestha A,1 Shrestha R,2 Sedhai LB,1 Pandit U1
1Department of Obstetrics and Gynecology
2Department of Pathology
Chitwan Medical College Teaching Hospital Bharatpur, Nepal.