Risk factors for uterine adenomyosis diagnosed by MRI in women of reproductive age

Adenomyosis is a condition characterized by the presence of endometrial glands and stroma within the myometrium. It can manifest as either focal or diffuse. While histopathological examination of the uterus following hysterectomy remains the gold standard for definitive diagnosis, non-invasive imaging techniques, particularly magnetic resonance imaging (MRI), are crucial for diagnosis. This study aimed to investigate the risk factors and associated pathologies in women with MRI-confirmed adenomyosis.

In this case-control study, 50 women of reproductive age with MRI-confirmed adenomyosis were recruited as the case group, and fifty other women who underwent pelvic MRI due to various indications that were not diagnosed as adenomyosis were included as the control group. Pelvic MRI with and without intravenous contrast was done for all patients. Factors such as age, smoking, number of pregnancies, history of uterine surgery, endometriosis, ovarian cyst, and coexisting leiomyoma were searched and recorded in both groups, and their relationship with uterine adenomyosis was statistically analyzed. The software used was IBM-SPSS v.26. A Significance level of less than 5% was considered.

No significant difference was found in terms of age (P = 0.891), smoking (P = 0.999), coexisting leiomyoma (P = 0.687), and ovarian cysts (P = 1.00) between case and control groups. The prevalence of endometriosis (P < 0.0001), history of uterine surgery (P = 0.002), and number of pregnancies (P = 0.012) were significantly higher in the case group.

The study findings suggest significant associations between endometriosis, number of pregnancies, and history of uterine surgery with adenomyosis. Therefore, managing these risk factors appropriately can substantially reduce the occurrence of adenomyosis.