benign uterine masses part 2

Question 1

what is adenomyosis ?

Answer 1

it is the benign invasion by the endometrium into the myometrium with the presence of stroma and glands in the endometrium

Question 2

what is the most common clinical presentation of adenomyosis ?

Answer 2

a 40 year old woman who is multi para complaining of
premenopausal bleeding
pelvic organ symptoms

Question 3

what are the signs of adenomyosis ?

Answer 3

uterus is tender on examination, symmetrically enlarged not exceeding the size of 10 weeks

Question 4

what investigations could be done in a case of suspected adenomyosis ?

Answer 4

sound
TVS
MRI
CBC ( to exclude other causes of menorrhagia )

Question 5

what are the differential diagnosis of adenomyosis ?

Answer 5

interstitial fibroids

other causes of symmetrical enlargement of the uterus

Question 6

what is the primary mode of investigation in adenomyosis ?

Answer 6

TVS ( transvaginal ultrasound)

Question 7

what is the best line of treatment ?

Answer 7

hysterectomy

Question 8

what is the initial line of treatment ?

Answer 8

NSAIDS 
anti-fibrinolytics 
gestagens 
hormonal IUD (Mirena) 
GnRH analogue