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Related Experiment Video

Updated: Jun 20, 2026

Intraoperative Detection of Subtle Endometriosis: A Novel Paradigm for Detection and Treatment of Pelvic Pain Associated with the Loss of Peritoneal Integrity
07:20

Intraoperative Detection of Subtle Endometriosis: A Novel Paradigm for Detection and Treatment of Pelvic Pain Associated with the Loss of Peritoneal Integrity

Published on: December 21, 2012

Adenomyosis: still largely under-diagnosed.

S Basak1, A Saha

  • 1Department of Obstetrics and Gynaecology, Diana, Princess of Wales Hospital, Grimsby, mayabasu@aol.com UK. sambitakar@yahoo.co.in [corrected]

Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology
|August 22, 2009
PubMed
Summary

Adenomyosis is frequently undiagnosed, leading to failed treatments for abnormal uterine bleeding and pelvic pain. Earlier diagnosis requires thorough history, clinical exam, ultrasound, and MRI correlation.

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Last Updated: Jun 20, 2026

Intraoperative Detection of Subtle Endometriosis: A Novel Paradigm for Detection and Treatment of Pelvic Pain Associated with the Loss of Peritoneal Integrity
07:20

Intraoperative Detection of Subtle Endometriosis: A Novel Paradigm for Detection and Treatment of Pelvic Pain Associated with the Loss of Peritoneal Integrity

Published on: December 21, 2012

Area of Science:

  • Gynecology
  • Reproductive Medicine
  • Medical Diagnostics

Background:

  • Adenomyosis is a common cause of abnormal uterine bleeding (AUB) and pelvic pain.
  • Current diagnostic approaches often overlook adenomyosis, leading to treatment failures for AUB and pelvic pain.
  • Reliance on ultrasound scans (USS) and incomplete patient history contribute to missed diagnoses.

Purpose of the Study:

  • To highlight the underdiagnosis of adenomyosis in patients with AUB and pelvic pain.
  • To emphasize the limitations of current diagnostic methods for adenomyosis.
  • To advocate for improved diagnostic strategies for adenomyosis.

Main Methods:

  • Retrospective cohort analysis of patients with AUB and pelvic pain.
  • Review of clinical notes, imaging findings (USS), and hysteroscopy reports.
  • Comparison of pre-hysterectomy diagnosis with post-hysterectomy pathology.

Main Results:

  • Adenomyosis was an underlying cause of treatment failure in a significant proportion of patients.
  • Clinicians rarely considered adenomyosis as a differential diagnosis for AUB.
  • Pelvic pain, dyspareunia, and dysmenorrhea symptoms were often not adequately queried.
  • Enlarged uterus findings were frequently not correlated with potential adenomyosis.
  • Ultrasound scan (USS) limitations and over-reliance on its findings contributed to missed diagnoses.

Conclusions:

  • Underlying adenomyosis is a frequent cause of treatment failure for abnormal uterine bleeding and pelvic pain.
  • Improved diagnostic strategies, including detailed history, clinical correlation, USS, and MRI, are crucial for earlier adenomyosis detection.
  • Early diagnosis allows for appropriate patient counseling regarding conservative management outcomes and timely consideration of hysterectomy for persistent symptoms.