adenomyosis Flashcards
what- adenomyosis?
The presence of functional endometrial tissue (endometrial glands and stroma) within the myometrium
cause- adenomyosis?
Thought to occur when the endometrium is allowed to communicate with the underlying myometrium after uterine damage; such interaction may occur in association with:
- Pregnancy and childbirth
-Caesarean section
- Uterine surgery (e.g endometrial curettage)
-Surgical management of miscarriage or termination of pregnancy
presentation- adenomyosis?
-menorrhagia (prolonged and increased menstrual flow)
-dysmenorrhoea (throbbing or cramping pains in lower abdomen)
-dyspareunia (genital pain before, during or after sex)
-irregular bleeding
Very long heavy periods
how is adenomyosis diagnosed?
definite diagnosis is through biopsy after hysterectomy
Hysterectomy:
-shows lots of cystic spaces
Histologically:
-endometrial glands surrounded by endometrial stroma within the myometrium
Imaging can also assist diagnosis:
-transvaginal US
-MRI
what is seen on hysterectomy of adenomyosis?
shows lots of cystic spaces
what is seen in histology for adenomyosis?
endometrial glands surrounded by endometrial stroma within the myometrium
what imaging can be used for assisting with the diagnosis of adenomyosis?
transvaginal US
MRI = best
what is the only curative option for adenomyosis?
hysterectomy
what are some conservative management options for symptom control- adenomyosis
-combined oral contraceptive pill
-progesterones (oral or intrauterine system e.g. mirena)
-GnRH analogues
-Aromatase inhibitors
what is a short/medium treatment option for women with adenomyosis who want to preserve fertility?
Uterine artery embolization
signs- adenomyosis?
enlarged boggy uterus
