title: Correlations between extent and spread of adenomyosis and clinical symptoms.
abstract: OBJECTIVE
  To correlate the histopathology of adenomyosis particularly the depth and spread of adenomyosis and symptomatology.
  
  
  METHODS
  Medical records of 94 patients who had undergone a hysterectomy and who were found to have adenomyosis on histopathologic examination were reviewed and histopathologic slides were reexamined. The symptoms were correlated with the presence of adenomyosis, the depth of penetration, and the spread of adenomyosis foci.
  
  
  RESULTS
  Specimens were stratified according to the degree of adenomyosis penetration into 4 groups: group A consisted of specimens with adenomyosis penetration into the myometrium of up to 25%; group B, 26-50%; group C, 51-75%, and group D, >75%. There was a significant correlation between the depth of penetration and the number of adenomyosis foci (r = 0.3446; p = 0.0001). Hemosiderin deposition was found mainly in the specimens with penetration of >75%. The symptoms did not correlate with the degree of penetration (r = 0.088; p NS). However, the spread of adenomyosis correlated significantly with pelvic pain (r = 0.80, p = 0.02), and with dysmenorrhea (r = 0.81, p = 0.01), but not with menorrhagia or dyspareunia.
  
  
  CONCLUSIONS
  Hemosiderin deposition and adenomyosis foci are found predominantly in specimens with deep adenomyosis penetration. It suggests that the deeper the penetration, the more extensive the adenomyosis. Symptoms of adenomyosis do not correlate with the depth of penetration, but there is a correlation between the spread of adenomyosis and pelvic pain, and dysmenorrhea.
authors.affiliation: Department of Obstetrics and Gynecology and Department of Pathology, McGill University, Montreal, Que, Canada.
authors.forename: Aref
authors.initials: A
authors.lastname: Sammour
authors.forename: Imran
authors.initials: I
authors.lastname: Pirwany
authors.forename: Alp
authors.initials: A
authors.lastname: Usubutun
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Arseneau
authors.forename: Togas
authors.initials: T
authors.lastname: Tulandi
mesh_terms: D000328:Adult; D004412:Dysmenorrhea / Q000453:epidemiology; D004414:Dyspareunia / Q000453:epidemiology; D004715:Endometriosis / Q000473:pathology* / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008595:Menorrhagia / Q000453:epidemiology; D008875:Middle Aged; D017699:Pelvic Pain / Q000453:epidemiology