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Clinical characteristics indicating adenomyosis at the time of hysterectomy: a retrospective study in 291 patients

  • General Gynecology
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Archives of Gynecology and Obstetrics Aims and scope Submit manuscript



To better characterize adenomyosis as a disease entity.


We retrospectively reviewed the medical records of women undergoing hysterectomy with a histologic diagnosis of adenomyosis, adenomyosis and leiomyomas, and leiomyomas alone.


The study included 291 women: 38 with adenomyosis alone, 56 with adenomyosis and leiomyomas, and 197 with leiomyomas alone. In univariate analysis, women with adenomyosis were younger (p = 0.018) and had lower uterine weights (p < 0.001) and more disease-specific symptoms (p = 0.008). In multinomial logistic regression analysis, a lower uterine weight (OR 0.99, CI 95% 0.99–1.0), pelvic pain (OR 4.8, CI 95% 1.5–15.2), a history of smoking (OR 2.6, CI 95% 1.1–6.5) and at least one delivery (OR 4.3, CI 95% 1.5–12.3) were associated with a greater likelihood of having adenomyosis but not leiomyomas alone.


Women undergoing hysterectomy with adenomyosis alone have different clinical characteristics from women with adenomyosis and leiomyomas and from those with only leiomyomas.

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  1. Ferenczy A (1998) Pathophysiology of adenomyosis. Hum Reprod Update 4(4):312–322

    Article  PubMed  CAS  Google Scholar 

  2. Azziz R (1989) Adenomyosis: current perspectives. Obstet Gynecol Clin North Am 16(1):221–235

    PubMed  CAS  Google Scholar 

  3. Walker CL, Stewart EA (2005) Uterine fibroids: the elephant in the room. Science 308:1589–1592

    Article  PubMed  CAS  Google Scholar 

  4. Fernandez H, Farrugia M, Jones SE, Mauskopf JA, Oppelt P, Subramanian D (2009) Rate, type, and cost of invasive interventions for uterine myomas in Germany, France, and England. J Minim Invasive Gynecol 16(1):40–46

    Article  PubMed  Google Scholar 

  5. Brucker S, Solomayer E, Zubke W, Sawalhe S, Wattiez A, Wallwiener D (2007) A newly developed morcellator creates a new dimension in minimally invasive surgery. J Minim Invasive Gynecol 14(2):233–239

    Article  PubMed  CAS  Google Scholar 

  6. Stewart EA (2001) Uterine fibroids. Lancet 357:293–298

    Article  PubMed  CAS  Google Scholar 

  7. Shaikh H, Khan KS (1990) Adenomyosis in Pakistani women: four year experience at the Aga Khan University Medical Centre, Karachi. J Clin Pathol 43:817–819

    Article  PubMed  CAS  Google Scholar 

  8. Vercellini P, Parazzini F, Oldani S, Panazza S, Bramante T, Crosignani PG (1995) Adenomyosis at hysterectomy: a study on frequency distribution and patient characteristics. Human Reprod 10:1160–1162

    CAS  Google Scholar 

  9. Vavilis D, Agorastos T, Tzafetas J, Loufopoulos A, Vakiani M, Constantinidis T et al (1997) Adenomyosis at hysterectomy: prevalence and relationship to operative findings and reproductive and menstrual factors. Clin Exp Obstet Gynecol 24:36–38

    PubMed  CAS  Google Scholar 

  10. Parazzini FVP, Panazza S, Chatenoud L, Oldani S, Crosignani PG (1997) Risk factors for adenomyosis. Hum Reprod 12:1275–1279

    Article  PubMed  CAS  Google Scholar 

  11. Weiss G, Maseelall P, Schott LL, Brockwell SE, Schocken M, Johnston JM (2009) Adenomyosis a variant, not a disease? Evidence from hysterectomized menopausal women in the Study of Women’s Health Across the Nation (SWAN). Fertil Steril 91:201–206

    Article  PubMed  Google Scholar 

  12. Parazzini F, Mais V, Cipriani S, Busacca M, Venturini P (2009) GISE. Determinants of adenomyosis in women who underwent hysterectomy for benign gynecological conditions: results from a prospective multicentric study in Italy. Eur J Obstet Gynecol Reprod Biol 143(2):103–106

    Article  PubMed  CAS  Google Scholar 

  13. Taran FA, Weaver AL, Coddington CC, Stewart EA (2010) Understanding adenomyosis: a case control study. Fertil Steril 94(4):1223–1228

    Article  PubMed  Google Scholar 

  14. R Development Core Team (2010) R: a language and environment for statistical computing. R Development Core Team, R Foundation for Statistical Computing, Vienna.

  15. Taran FA, Weaver AL, Coddington CC, Stewart EA (2010) Characteristics indicating adenomyosis coexisting with leiomyomas: a case-control study. Hum Reprod 25(5):1177–1182

    Article  PubMed  Google Scholar 

  16. Vercellini P, Vigano P, Somigliana E, Daguati R, Abbiati A, Fedele L (2006) Adenomyosis: epidemiological factors. Best Pract Res Clin Obstet Gynaecol 20:465–477

    Article  PubMed  Google Scholar 

  17. Levgur M, Abadi MA, Tucker A (2000) Adenomyosis: symptoms, histology, and pregnancy terminations. Obstet Gynecol 95:688–691

    Article  PubMed  CAS  Google Scholar 

  18. Panganamamula UR, Harmanli OH, Isik-Akbay EF, Grotegut CA, Dandolu V, Gaughan JP (2004) Is prior uterine surgery a risk factor for adenomyosis? Obstet Gynecol 104:1034–1038

    Article  PubMed  Google Scholar 

  19. Olive DL, Franklin RR, Gratkins LV (1982) The association between endometriosis and spontaneous abortion. A retrospective clinical study. J Reprod Med 27:333–338

    PubMed  CAS  Google Scholar 

  20. Van Voorhis BJ, Dawson JD, Stovall DW, Sparks AE, Syrop CH (1996) The effects of smoking on ovarian function and fertility during assisted reproduction cycles. Obstet Gynecol 88(5):785–791

    Article  PubMed  Google Scholar 

  21. Kitawaki J (2006) Adenomyosis: the pathophysiology of an oestrogen-dependent disease. Best Pract Res Clin Obstet Gynaecol 20(4):493–502

    Article  PubMed  Google Scholar 

  22. Yeniel O, Cirpan T, Ulukus M, Ozbal A, Gundem G, Ozsener S, Zekioglu O, Yilmaz H (2007) Adenomyosis: prevalence, risk factors, symptoms and clinical findings. Clin Exp Obstet Gynecol 34(3):163–167

    PubMed  CAS  Google Scholar 

  23. Lu HF, Sheu BC, Shih JC, Chang YL, Torng PL, Huang SC (1997) Intramural ectopic pregnancy. Sonographic picture and its relation with adenomyosis. Acta Obstet Gynecol Scand 76(9):886–889

    Article  PubMed  CAS  Google Scholar 

  24. Saraiya M, Berg CJ, Kendrick JS, Strauss LT, Atrash HK, Ahn YW (1998) Cigarette smoking as a risk factor for ectopic pregnancy. Am J Obstet Gynecol 178(3):493–498

    Article  PubMed  CAS  Google Scholar 

  25. Garcia L, Isaacson K (2011) Adenomyosis: review of the literature. J Minim Invasive Gynecol 18(4):428–437

    Article  PubMed  Google Scholar 

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Correspondence to F. Andrei Taran.

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F. A. Taran and M. Wallwiener have contributed equally to this work.

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Taran, F.A., Wallwiener, M., Kabashi, D. et al. Clinical characteristics indicating adenomyosis at the time of hysterectomy: a retrospective study in 291 patients. Arch Gynecol Obstet 285, 1571–1576 (2012).

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