Adenomyosis and coexisting gynecologic pathologies: How often do they coexist?

To evaluate the presence of gynecologic pathologies accompanying adenomyosis among the hysterectomy specimens performed for various gynecologic indications.

This multicenter retrospective cohort study included women who underwent hysterectomy for various gynecologic indications and were diagnosed with adenomyosis at tertiary care centers. Eligible women were classified into two groups based on histopathologic results: Group 1-patients with only adenomyosis (n = 102) and Group 2-patients with adenomyosis and other gynecologic pathologies (n = 1353). Demographic and clinical characteristics, ultrasound examinations, and pathology reports were collected from medical records, and differences between the groups were assessed regarding clinical and demographic data, preoperative evaluations, and surgical characteristics.

A total of 1455 patients were included. The adenomyosis-only group was significantly older than the group with other gynecologic pathologies. The most common coexisting condition was myoma uteri, found in 586 patients (43.3%), followed by cancer and endometrial polyp. Myoma uteri was the most common comorbidity in premenopausal women, but cancer was more prevalent in postmenopausal patients. The mean endometrial thickness was less in the adenomyosis-only group (6.5 ± 4.7 versus 8.0 ± 7.1 mm, P = 0.032). Adenomyosis was more frequent in patients with menstrual irregularities compared with pelvic pain and postmenopausal bleeding. Conversely, cancer was significantly more common in patients with postmenopausal bleeding. Overall, 351 (24.1%) patients were diagnosed with cancer, with endometrial cancer being the most common (n = 218, 62.1%).

Our findings suggest that adenomyosis is frequently associated with conditions such as myoma uteri, endometrial polyps, and endometrial cancer.