Characteristics indicating adenomyosis coexisting with leiomyomas: a case-control study
Open Access
- 22 February 2010
- journal article
- research article
- Published by Oxford University Press (OUP) in Human Reproduction
- Vol. 25 (5), 1177-1182
- https://doi.org/10.1093/humrep/deq034
Abstract
Adenomyosis is rarely diagnosed before hysterectomy and commonly coexists with uterine leiomyomas. The objective of this study was to identify distinct features of a concurrent diagnosis of adenomyosis in women with uterine leiomyomas. We conducted a case–control study of women undergoing hysterectomy with a histologic diagnosis of both adenomyosis and leiomyomas and women with uterine leiomyomas but no adenomyosis. A retrospective medical record review of hospital and ambulatory records was performed to ascertain sociodemographic and anthropometric variables, as well as to confirm intraoperative and pathologic findings. Our study sample comprised 255 patients, 85 women with adenomyosis and leiomyomas and 170 women with only leiomyomas. In multivariable logistic regression analyses, women with adenomyosis and leiomyomas were more likely to have more pelvic pain [odds ratio (OR) 3.4, 95% confidence interval (CI) 1.8–6.4], have less fibroid burden (OR per doubling in fibroid size 0.6, 95% CI 0.5–0.8), were more likely to be parous (OR 3.8, 95% CI 1.4–10.5) and have lower body mass index (OR per 5 unit increase in BMI 0.8, 95% CI 0.6–1.0) when compared with women with leiomyomas alone. Women undergoing hysterectomy with both adenomyosis and leiomyomas have a number of different clinical features compared with women with only leiomyomas at the time of hysterectomy. Women with substantial pain despite a smaller fibroid burden may be more likely to have concomitant adenomyosis.Keywords
This publication has 34 references indexed in Scilit:
- Adenomyosis: epidemiological factorsBest Practice & Research Clinical Obstetrics & Gynaecology, 2006
- Uterine fibroids and gynecologic pain symptoms in a population-based studyFertility and Sterility, 2003
- A prospective study of reproductive factors and oral contraceptive use in relation to the risk of uterine leiomyomataFertility and Sterility, 1998
- Variation in the Incidence of Uterine Leiomyoma Among Premenopausal Women by Age and RaceObstetrics & Gynecology, 1997
- Risk factors for adenomyosisHuman Reproduction, 1997
- Adenomyosis at hysterectomy: prevalence and relationship to operative findings and reproductive and menstrual factors.1997
- Surgery: Adenomyosis at hysterectomy: a study on frequency distribution and patient characteristicsHuman Reproduction, 1995
- Adenomyosis in Pakistani women: four year experience at the Aga Khan University Medical Centre, Karachi.Journal of Clinical Pathology, 1990
- Adenomyosis: a retrospective view.1989
- The meaning and use of the area under a receiver operating characteristic (ROC) curve.Radiology, 1982