Adenomyosis

Adenomyosis


INTRODUCTION:

  • Adenomyosis is a condition in which the inner lining of the uterus (the endometrium) breaks through the muscle wall of the uterus (the myometrium). 
  • Adenomyosis is a common condition.
  • It is most often diagnosed in middle-aged women and women who have had children.

ETIOLOGY:

  • Hormones : including estrogen, progesterone, prolactin, and follicle stimulating hormone — may trigger the condition.
  • Some studies also suggest that women who have had prior uterine surgery may be at risk for adenomyosis.

CLASSIFICATION:

  • Focal: As the name indicates, focal adenomyosis is adenomyosis in one particular site of the uterus.
  • Adenomyoma: Adenomyoma is a form of focal adenomyosis, but it is more extensive, as it results in a uterine mass or benign tumor, similar to uterine fibroma.
  • Diffuse: Unlike the other two classifications, diffuse adenomyosis is spread throughout the uterus

SYMPTOMS:

While some women diagnosed with adenomyosis have no symptoms, the disease can cause:

  • Heavy, prolonged menstrual bleeding
  • Severe menstrual cramps
  • Infertility
  • Abdominal pressure and bloating
  • Painful periods and cramps (dysmenorrhea)
  • Heavy menstrual bleeding (menorrhagia), which can include clots
  • Painful bowel movement (dyschezia)
  • Bladder symptoms including uncomfortable urination (dysuria), burning urination or blood in the urine (hematuria)
  • Peripheral nerve numbness or weakness (neuropathy), which can cause leg or bowel pain during periods
  • Pain upon sexual intercourse (dyspareunia)
  • Inflammation of the uterus
  • Deficiency of blood cells or hemoglobin (anemia)
  • No symptoms: It can be common for some woman to present with no symptoms at all and not even know they have the disease  
DIAGNOSIS:
  • Physical examination
  • MRI
  • Transvaginal ultrasound
TREATMENT:

Non-surgical:Drugs

Surgical:

  • Laparoscopic deep excision surgery within the uterus:This is the gold standard for minimally invasive excision surgery of adenomyosis that is classified as either focal or adenomyoma.
  • Total Hysterectomy or partial hysterectomy:This is a surgical technique in which the uterus or part of the uterus is removed. It should be performed with caution and only in cases of severe diffuse adenomyosis.
Exam Question
 
  • Infertility is seen in Adenomyosis 
  • Adenomyosis is Presents with menorrhagia, dysmenorrhea and an enlarged uterus
  • Symptoms of adenomyosis Menorrhagia & Dysmenorrhea
  • Treatment of adenomyosis is Total hysterectomy
Don’t Forget to Solve all the previous Year Question asked on Adenomyosis

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