Phenotypic heterogeneity in adenomyosis: internal and external subtypes

Area of Science:

• Gynecology
• Reproductive Medicine
• Medical Imaging

Background:

• Adenomyosis (AM) is a common gynecological condition.
• Intrinsic and extrinsic subtypes of AM present with varying clinical manifestations.
• Understanding these differences is crucial for accurate diagnosis and management.

Purpose of the Study:

• To compare clinical characteristics and risk factors of intrinsic and extrinsic adenomyosis (AM).
• To investigate differences in perioperative management and findings between intrinsic and extrinsic AM subtypes.

Main Methods:

• Observational study including women diagnosed with intrinsic or extrinsic AM via MRI.
• Hysterectomy and pathological examination were performed.
• Evaluation of demographic data, clinical features, treatment outcomes, and associated factors.

Main Results:

• Intrinsic AM group (77 patients) showed higher gravidity, parity, abortion rates, and endometrial curettage history, with lower education levels.
• Extrinsic AM group (54 patients) had earlier menarche, more frequent ovarian endometrioma (OMA) and deep infiltrating endometriosis (DIE).
• Extrinsic AM was associated with more severe dysmenorrhea, longer surgery times, greater blood loss, higher costs, and intensive postoperative treatment.

Conclusions:

• Intrinsic and extrinsic adenomyosis (AM) demonstrate specific clinical profiles.
• Distinct risk factors are associated with each subtype of AM.
• Perioperative characteristics and findings differ significantly between intrinsic and extrinsic AM.