[Uterine adenomyosis. Clinical and therapeutic study. Report of 87 cases]

The aim of our study is the analysis of Pound epidemiological, clinical, paraclinical and therapeutic aspects of adenomyosis.

A retrospective analysis was carried out on 87 patients who underwent hysterectomy for a variety of reasons (except for prolapse) between January 1, 1990, and December 31, 1997; and whose Histologic analysis of hysterectomy specimen revealed adenomyosis.

586 hysterectomy (except prolapse) was performed during the study period: frequency of adenomyosis in hysterectomy specimen is of 14.85%. The mean age of our patients is 43.97 years (Range: 26-64 years). 29.88% of them are postmenopausal and 41.37% had a past history of uterine trauma. Main symptoms were pelvic pain (71.22%) and abnormal uterine bleeding (82.77%). Preoperative diagnosis has been suspected on hysteroscopy in 63.22% of cases, hysterography in 58.46% and transvaginal sonography in 40.5%. A radical surgery first has been indicated in 57 cases, after failure of medical treatment in 16 cases and after failure of endometrial resection in 14 cases. Histologic analysis of the hysterectomy specimen shows associated myoma in 32.18% of cases, hyperplasia in 13.79%, polyps in 5.74% and atrophy in 3.44%.

Adenomyosis, enigmatic disease, escapes always to a well-codified therapeutic strategy and bound closely related to hysterectomy. Earliest diagnosis could avoid the systematic evolution toward the radical treatments.