Adenomyosis: Pathologies associated in a set of patients underwent hysterectomy

ObjectiveTo determine if a relationship exists between the histopathological diagnosis of adenomyosis and the clinical conditions and pathologies that are more commonly related to it in patients undergoing hysterectomy.MethodsRetrospective, comparative, case-control study was conducted. With previous approval by ethics committee, we included 794 patients undergoing hysterectomy at a University Hospital. The Medical records and pathology reports of patients undergoing hysterectomy over a two-year period were reviwed. Clinical conditions and associated pathologies, in patients with and without adenomyosis, were reviewed and compared. Statistical analysis was done using the Chi-square test.ResultsAdenomyosis was reported in 140 out of 794 patients, 17.6% (95% CI: 15.1–20.4). No differences in adenomyosis prevalence were found among patients with or without uterine fibroids, 20.2% (75/371) vs. 15.5% (65/423); endometrial polyps, 9.7% (6/62) vs. 18.3% (134/732); and the presence or lack of endometrial hyperplasia 13.9% (5/36) vs. 17.4% (135/758). The prevalence of adenomyosis among patients with endometriosis was 40.7% (11/27), and among those without this diagnosis, 16.8% (129/767). This difference was significant (P=0.001). A history of two or more curettages was also positively related to adenomyosis.ConclusionsThere was a statistically significant difference in the prevalence of adenomyosis in women with endometriosis when compared to women without endometriosis. A higher incidence of adenomyosis was found in patients with a history of two or more curettages. Trauma to the endometrium could explain the higher incidence of adenomyosis in both conditions.