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

Hale Goksever Celik1,2, Ipek Betul Ozcivit Erkan3, Elif Goknur Topcu4

  • 1Department of Obstetrics and Gynecology, Faculty of Medicine, Acibadem University, Istanbul, Türkiye.

International Journal of Gynaecology and Obstetrics: the Official Organ of the International Federation of Gynaecology and Obstetrics
|May 31, 2025
PubMed
Summary

Adenomyosis frequently co-occurs with other gynecologic conditions, including uterine fibroids, endometrial polyps, and cancer. This study highlights the importance of considering these associations in diagnosis and treatment planning.

Keywords:
adenomyosisendometrial cancerepidemiologygynecologic pathologiesmyoma uteririsk factor

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Area of Science:

  • Gynecologic Oncology
  • Reproductive Medicine
  • Pathology

Background:

  • Adenomyosis is a common benign gynecologic condition.
  • It often coexists with other uterine pathologies, impacting patient management.
  • Understanding these associations is crucial for accurate diagnosis and treatment.

Purpose of the Study:

  • To investigate the prevalence and types of gynecologic pathologies accompanying adenomyosis.
  • To compare clinical and demographic characteristics of patients with adenomyosis alone versus those with coexisting conditions.
  • To identify risk factors and patterns associated with these comorbidities.

Main Methods:

  • Multicenter retrospective cohort study of 1455 women undergoing hysterectomy.
  • Classification into groups: adenomyosis only (n=102) vs. adenomyosis with other pathologies (n=1353).
  • Analysis of demographic data, clinical characteristics, ultrasound findings, and pathology reports.

Main Results:

  • The most common coexisting pathology was myoma uteri (43.3%), followed by cancer and endometrial polyps.
  • Cancer was more prevalent in postmenopausal patients, particularly endometrial cancer (24.1% overall).
  • Adenomyosis was more frequent in patients with menstrual irregularities compared to pelvic pain or postmenopausal bleeding.

Conclusions:

  • Adenomyosis is frequently associated with myoma uteri, endometrial polyps, and endometrial cancer.
  • The study underscores the need for comprehensive evaluation in patients diagnosed with adenomyosis.
  • Further research into the etiological links between adenomyosis and these comorbidities is warranted.