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[Adenomyosis].

H Fernandez1, A-C Donnadieu

  • 1Service de Gynécologie - Obstétrique et d'Histologie - Embryologie - Cytogénétique à Orientation Biologique et Génétique de la Reproduction, Hôpital Antoine-Béclère, APHP, 92141 Clamart cedex, France. herve.fernandez@abc.ap-hop-paris.fr

Journal De Gynecologie, Obstetrique Et Biologie De La Reproduction
|February 3, 2007
PubMed
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Diagnosis of adenomyosis relies on pathologists, with symptomatic cases causing pain or bleeding. Treatment options range from hysterectomy for non-pregnant patients to medical therapies like IUDs and Gn-RH analogs.

Area of Science:

  • Gynecology
  • Pathology
  • Radiology

Context:

  • Adenomyosis, a condition often asymptomatic, presents diagnostic challenges.
  • Symptomatic adenomyosis manifests as pelvic pain and abnormal uterine bleeding.
  • Current diagnostic strategies involve pathology, sonography, and MRI, with varying utility.

Purpose:

  • To outline the diagnostic and therapeutic strategies for adenomyosis.
  • To evaluate the roles of different imaging modalities and treatments.
  • To provide an evidence-based approach to managing adenomyosis.

Summary:

  • Pathologist diagnosis is definitive (Grade A).
  • Sonography offers good sensitivity for diagnosis and is key in therapeutic planning (Grade B).
  • MRI is valuable for identifying associated lesions (Grade B).

Related Experiment Videos

  • Hysterectomy is the primary surgical option for symptomatic women not desiring pregnancy (Grade B).
  • Medical treatments include levonorgestrel-releasing IUDs, Gn-RH analogs, and progestins (Grade C).
  • Endometrial resection/destruction is indicated for menorrhagia (Grade C).
  • Hysterosalpingography is not recommended for diagnosis (Grade B).
  • Uterine artery embolization is not advised.

    • Impact:

    • This review clarifies diagnostic pathways and treatment selection for adenomyosis.
    • It emphasizes the importance of tailored management based on symptoms and reproductive status.
    • Provides a framework for clinicians managing adenomyosis patients.