Symptom Burden in Adenomyosis: A Comparative Analysis With Peritoneal and Deep Infiltrating Endometriosis
Elvin Piriyev1,2, Clara Mennicken2,3, Sven Schiermeier4
1University Witten-Herdecke, Witten, Germany; piriyev.elvins@gmail.com.
Background/Aim:
Adenomyosis frequently coexists with endometriosis and shares overlapping symptoms; however, the symptom burden of isolated adenomyosis remains insufficiently defined. The aim of this study was to compare the severity and distribution of symptoms in patients with isolated adenomyosis versus those with peritoneal/ovarian endometriosis and deep infiltrating endometriosis (DIE).
Patients And Methods:
This retrospective study analyzed standardized preoperative symptom questionnaires from women who underwent surgery for suspected endometriosis at a tertiary referral center in 2021. Patients were classified intraoperatively using the #ENZIAN system and allocated to three groups: isolated adenomyosis (AM), peritoneal/ovarian endometriosis with or without adenomyosis, and DIE with or without additional disease.
Results:
A total of 231 patients were included (isolated AM: n=42; peritoneal/ovarian endometriosis: n=120; DIE: n=69). Dysmenorrhea was highly prevalent across all groups (95-100%). Chronic pelvic pain and dyspareunia, including severe dyspareunia, were reported more frequently in patients with isolated AM and peritoneal/ovarian disease than in those with DIE (p<0.05). Gastrointestinal symptoms were common across all groups without significant differences. Patients with DIE showed significantly higher rates of ovarian involvement and tubo-ovarian adhesions (p<0.001).
Conclusion:
AM is associated with a symptom burden comparable to that of peritoneal and DIE. These findings underscore adenomyosis as a clinically significant cause of pelvic pain and highlight the need for early recognition and appropriate management.
Related Concept Videos
Disorders of the Female Reproductive System
Appendicitis
Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
Appendicitis-I: Introduction
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Inflammatory Bowel Disease IV: Clinical Manifestations
Assessment of the Rectum and Anus
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...


