Characteristics indicating adenomyosis at the time of hysterectomy: a retrospective study of 291 patients

Introduction:

The objective of this study was to elucidate the clinical profile of adenomyosis by comparison with uterine leiomyomas.

Material and methods:

We conducted a retrospective study of women undergoing hysterectomy for benign disease with a histologic diagnosis of adenomyosis, a diagnosis of both adenomyosis and leiomyomas and women with uterine leiomyomas but no adenomyosis. A retrospective medical record review was performed to ascertain sociodemographic and anthropometric variables, as well as to confirm intraoperative and pathologic findings.

Results:

Our study sample comprised 291 patients, 38 women with adenomyosis, 56 women with adenomyosis and leiomyomas and 197 women with only leiomyomas. In multinomial logistic regression analyses, women with adenomyosis were associated with older age [odds ratio (OR) 0,9; 95% confidence interval (CI) 0,8–1,0], a history of smoking (OR 3,72; 95% CI 1,2–11,3), were more likely to be parous (OR 7,5; 95% CI 2,4–23,6) when compared with women with adenomyosis and leiomyomas. Women with leiomyomas were associated with older age (OR 0,9; 95% CI 0,9–1,0) when compared with women with adenomyosis and leiomyomas. Finally, women with adenomyosis had a lower uterine weight (OR 1,0; 95% CI 0,9–1,0), were more likely to have more pelvic pain (OR 4,8; 95% CI 1,5–15,2), were more likely to have a history of smoking (OR 2,6; 95% CI 1,1–6,5) and were more likely to be parous (OR 4,3; 95% CI 1,5–12,3) when compared with women with leiomyomas.

Conclusions:

Women undergoing hysterectomy with adenomyosis and with both adenomyosis and leiomyomas have a number of different features compared with women with only leiomyomas at the time of hysterectomy. Better understanding of this disease is required to improve diagnosis and management.