Published: 2017-06-24

A retrospective study of the clinical features of 50 consecutive cases diagnosed to have adenomyosis by histopathology in hysterectomy specimens in a tertiary centre

Sreelakshmy K., Rema V. Nair, Rajmohan V.


Background: Adenomyosis is characterised by the presence of ectopic endometrium, both glands and stroma deep in myometrium. Myometrial weakness caused by previous surgery or pregnancies, genetic factors, and tamoxifen use has been proposed as some aetiological factors.

Methods: Present study aims to study the clinical profile of patients who have histological evidence of adenomyosis in hysterectomy specimens. The records of consecutive patients who had undergone hysterectomy were analysed.

Results: The commonest age group affected is 41-50 years and menorrhagia is the predominant symptom.  The preoperative diagnosis of adenomyosis remains poor at around 8%.

Conclusions: The age of onset and clinical features of patients should serve as an index for suspecting adenomyosis.


Adenomyosis, Dysmenorrhea, Hysterectomy, Menorrhagia

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Hoffman BL. Pelvic mass. Williams Gynaecology. 2nd ed. Texas: MC Graw Hill; 2008:259-61.

Emge LA. Elusive adenomyosis of uterus. Its historical part and its present state of recognition. Am J Obstet Gynaecol. 1962;83:1541-63.

Cohen I, Beyth Y, Shapira J, Tepper R, Fishman A, Cordoba M et al. A high frequency of adenomyosis in post menopausal breast cancer patients who were treated with tamoxifen. Gynaecol Obstet Invest. 1997;44(3):200-5.

Weiss G, Maseelall P, Schott LL. Adenomyosis is a variant, not a disease? Evidence from hysterectomized menopausal women in the Study of Women’s Health Across the Nation (SWAN). Fertil Steril. 2009;91(1):201-6.

Shrestha A, Shrestha R, Sedhai LB. Adenomyosis at hysterectomy: prevalence patient characteristics, clinical profile and histopathological findings. Kathmandu University Med J. 2012;37(10):53-56.

Reinhold C, Tafazolu F, Wang L. The imaging features of adenomyosis. Hum Reprod Update. 1998;4:37-49.

Rapkin AJ, Nathan L. Pelvic pain and dysmenorrhea in: Bereck. Berek and Novaks Gynaecology. 15th ed. New Delhi:Wolters Kluwer Health India Pvt LTD; 2013:484-5.

Parazzini F, Vercellini P, Panazza S, Chatenoud L, Oldani S. The risk factors for adenomyosis. Hum Reprod. 1997;12:1275-9.

Vavilis D, Agorastos T, Tzafetas J. Adenomyosis at hysterectomy: its prevalence and its relationship to the operative findings and the reproductive and menstrual factors. Clin Exp Obstet Gynaecol. 1997;24:36-8.

Bazot M, Cortez A, Darai E, Rouger J, Chopier J, Antoine JM et al. Ultrasonography compared with magnetic resonance imaging for the diagnosis of adenomyosis: correlation with histopathology. Human Reprod. 2001;16(11):2427-33.

Rizvi C, Panday H. Histopathological Correlation of adenomyosis and leiomyoma in hysterectomy specimens as the cause of abnormal uterine bleeding in women in different age groups in Kumaon region a retrospective study. J Mid-life Health. 2013;4(1):27-30.

Shaikh H, Khan KS. Adenomyosis in Pakistani women. Four years of experience at the Aga Khan University Medical Centre, Karachi. J Clin Pathol. 1990;43:817-9.

Sharqill SK, Sharqill HK, Gupta M, Kaur S. A clinicopathological study of hysterectomy. J Indian Med Assoc. 2002;100:238-9.

Ranabhat SK, Shrestha R, Tiwari M, Sinha DP, Subedee LR. A retrospective histopathological study of hysterectomy with or without salpingoophorectomy specimens. JCMC. 2010;1(1):26-29.

Khreisat B, Al-Rawabdeh S, Duqoum W. Adenomyosis: the frequency of hysterectomy in the histopathological specimens at two Jordanian military hospitals. JRMS. 2011;18(2):76-79.

Levgur M, Abadi MA, Tucker A. Adenomyosis: symptoms, histology and pregnancy terminations. Obstet Gynaecol. 2000;95:688-91.

Panganamamula UR, Harmanli OH, Isik-Akbay EF, Grotegut CA, Dandolu V, Gaughan JP. Is prior uterine surgery arsk factor for adenomyosis? Obstet Gynaecol. 2004;104:1034-8.