Prevalence of adenomyosis as a co-morbidity in patients who underwent hysterectomy for other indications

Abstract

Introduction: Adenomyosis is a common gynaecological condition that affects women of reproductive age group (20%-60%). The cardinal clinical features of adenomyosis are menorrhagia, dysmenorrhea and uterine enlargement. Classically, it was thought and compared with ultrasonography; MRI enables more accurate diagnosis of the disease when adenomyosis is suspected. Objective: To evaluate the clinical profile associated with adenomyosis, frequency distribution and to determine the prevalence of adenomyosis in patients undergoing hysterectomy for other indications, as well as to correlate clinical examination with histopathological examination. Methodology: It is a retrospective observational study which included 100 patients who underwent abdominal hysterectomy or vaginal hysterectomy for various indications. Age, parity, presenting complaints, elicited signs, indication for hysterectomy, and HPE report of the specimens were analyzed. All cases diagnosed as Adenomyosis and Endometriosis was excluded. Results: Among 100 women who underwent hysterectomy, Adenomyosis was found in 24 cases (24%). Menorrhagia (91.7%), chronic pelvic pain (83.3%), dysmenorrhea (79.2%), dyspareunia (16.7%) is the classic presentation. More common in multiparous women and begins later in reproductive life (mean age- 45yrs). (45.8%) had bulky uterus on per vaginal examination. Adenomyosis was present in 10 of 23 patients (43.47%) diagnosed as dysfunctional uterine bleeding; 6 of 24 (25%) with fibroid; 4 of 21 (19.04%) with prolapse; 2 of 14 (14.28%) with ovarian mass; 2 of 10 (20%) with pelvic inflammatory disease. Conclusion: The prevalence of unsuspected adenomyosis is found to be 24% in this study. Adenomyosis is common in women presenting with chronic pelvic pain, menorrhagia and dysmenorrhea. It is also common in multiparous women with bulky uterus and mean age being 45 years. In women with completed family and had failed medical therapy given for undiagnosed Adenomyosis the choice of thera