To identify the prevalence of Adenomyosis in patents who underwent hysterectomy for fibroid uterus, and to correlate patient profile, clinical finding and reproductive characteristics.
Methodology: This is a retrospective study conducted at ESIC Medical College and PGIMSR, Rajajinagar Bangalore. Women who underwent abdominal or vaginal hysterectomy for proven uterine leiomyomas on ultrasonography with or without oophorectomy in a 3 year period from 2013 to 2016 were included in the study. Retrospectively data was collected from medical records regarding age, parity, presenting symptoms, histopathological report of hysterectomy specimen for evidence of concurrent adenomyosis. Statistical analysis of data was carried out using SPSS statistical software. Quantative data were analysed with mean, median and standard deviation. Qualitative data (categorical) were analysed with percentages and frequencies.
Results: We had 180 patients who underwent hysterectomy with or without oophorectomy for fibroid uterus in our study period. Out of which 108(60%) patients were found to have adenomyosis. Adenomyosis was more commonly seen in patients with older age group than with patients with fibroid alone. The patients with concurrent adenomyosis significantly presented with dysmenorrhoea (P-0.001) and pelvic pain (P-<0.001), also the size of the uterus at the time of surgery was less than 12week in a significant population (P-0.243). Reproductive data between the two cohort, showed that significant patients with leiomyomas alone were nulliparous (P-0.015) and as parity increased to two or more the patients were prone to have concurrent Adenomyosis (P-0.008).
Conclusion: Our study shows that 60% of patients who underwent hysterectomy for fibroid uterus had concurrent Adenomyosis. Patients with concurrent Adenomyosis more frequently presented with Dysmenorrhoea and pelvic pain than with patients with fibroid alone. As the parity increased the risk of having co existing adenomyosis also increased significantly. A detail history obtained from the patients with reproductive history along with use of modern non-invasive diagnostic imaging modality like transvaginal ultrasonography, magnetic resonance imaging and nuclear magnetic resonance can aid in the diagnosis of Adenomyosis in patients prior to hysterectomy.