Obstetrics and Gynecology
Khor Chun Kit; Christine Na Sin Ee; Jackie Wong Kee Hung; Aiswaryaa Devi A/P Tambi Selvam; Chan Sue Vern; Lee Lionel; Hussein Akl; Kavitha Nagandla
Volume 8, Issue 2 , March and April 2023, , Pages 105-112
Abstract
Background & Objective: Adenomyosis is a common benign endometrial disease which causes abnormal uterine bleeding in premenopausal women and affects the quality of life. The definitive treatment is hysterectomy; however, medical treatment is an option for those who wish to preserve fertility. ...
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Background & Objective: Adenomyosis is a common benign endometrial disease which causes abnormal uterine bleeding in premenopausal women and affects the quality of life. The definitive treatment is hysterectomy; however, medical treatment is an option for those who wish to preserve fertility. This systematic review aims to assess the efficacy of levonorgestrel-releasing intrauterine device as medical management in women who have adenomyosis.Materials & Methods: We searched PubMed, Cochrane and Scopus databases from January 2000 to November 2019 for relevant studies containing the use of levonorgestrel-releasing intrauterine device (LNG-IUD) in managing patients with ultrasonographic diagnosis of adenomyosis. Main outcome measures in the study are menstrual blood loss (milliliters), pain score measured in 10 cm-visual analogue scale, and uterine volume.Results: Pooled results from meta-analysis showed that after LNG-IUD treatment for adenomyosis, there is significant reduction in dysmenorrhoea, measured using Visual Analogue Scale after 6 months (Standardized Mean Difference (SMD): 3.68; Cl: 2.11-5.25) , 12 months (SMD: 4.23; CI: 2.99-5.48), 24 months (SMD: 4.69; CI: 3.40-5.97) and 36 months (SMD: 4.01; CI: 3.57-4.45); significant reduction in menstrual bleeding after 6 months (SMD: 2.52; CI: 1.15-3.89), 12 months (SMD: 3.43; CI: 1.64-5.22) and 24 months (SMD: 3.57; CI: 1.88-5.26); significant reduction in uterine volume after 6 months (SMD: 0.49; CI: 0.04-0.93), 12 months (SMD: 0.80; CI: 0.11-1.48) and 24 months (SMD: 0.86; CI: 0.15-1.58).Conclusion: LNG-IUS is an effective method in alleviating the symptoms of adenomyosis. It is a valuable long-term alternative for the treatment of adenomyosis for young and perimenopausal women in terms of dysmenorrhoea and heavy menstrual bleeding.
Mohammad Ranaei; Emad Kohsari; Mina Galeshi; Shahla Yazdani
Volume 4, Issue 3 , September and October 2019, , Pages 99-104
Abstract
Background & Objective: Adenomyosis is a prevalent gynecological disorder among women with no specified causes. It is characterized by nonspecific symptoms, and can present itself as abnormal uterine bleeding, abdominal pain, menstrual disorders, and the like. Its diagnosis is made based on the pathologic ...
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Background & Objective: Adenomyosis is a prevalent gynecological disorder among women with no specified causes. It is characterized by nonspecific symptoms, and can present itself as abnormal uterine bleeding, abdominal pain, menstrual disorders, and the like. Its diagnosis is made based on the pathologic histological examination of hysterectomized samples. This study aimed to evaluate the correlation of adenomyosis with other benign endometrial disorders in hysterectomized samples.
Materials & Methods: In this paper a total of 413 patients who referred to Rouhani Hospital of Babol, form 2012 to 2017, and underwent a hysterectomy surgery with pathological reports confirming the diagnosis of adenomyosis, were studied. After reviewing the medical records, the patients’ data, including their age, weight, number of deliveries, place of residence, and main complaints at the time of referral as well as benign endometrial pathologies correlated with adenomyosis, were examined. Finally, the obtained data were analyzed using statistical tests.
Results: The prevalence of adenomyosis in this study was 21.7%. The patients’ most common complaints were abnormal uterine bleeding (86.4%), dysmenorrhea (39.2%), abdominal pain (31.2%), dyspareunia (21.1%), mass outflow (15%), and pelvic pain (9.4%). In the current study, the benign pathologies correlated with adenomyosis were leiomyoma (52.5%), uterine polyp (11.9%), adenomyoma (5.1%), and hyperplasia (0.5%).
Conclusion: In the present study, the prevalence of adenomyosis was high and abnormal uterine bleeding was the patients’ most prevalent complaint. Moreover, leiomyoma had the highest correlation with adenomyosis.