Uterine adenomyosis is associated with ultrastructural features of altered contractility in the inner myometrium.
OBJECTIVE
To study the ultrastructure of the inner and outer myometrium, in the presence and absence of uterine adenomyosis.


METHODS
Case control blinded comparison.


METHODS
University departments.


METHODS
Four premenopausal women with and six without uterine adenomyosis as the sole pathology.


METHODS
Multiple samples were studied using transmission electron microscopy.


METHODS
Ultrastructure feature of the myometrium.


RESULTS
In uteri with adenomyosis, the myocytes exhibited cellular hypertrophy. The cytoplasmic myofilaments were less abundant. Abundant intermediate filaments formed cytoplasmic aggregates. The nuclei had a smooth outline with a clear ground substance, prominent nucleoli and peripherally arranged nuclear chromatin. There was occasional infolding of the nuclear envelope with entrapment of cytoplasmic organelles. The sarcolemmal bands were significantly longer and there were fewer caveolae. The perinuclear cell organelles were more distinct. The rough endoplasmic reticulum and Golgi apparatus were more prominent, denoting active protein synthesis, consistent with the observed cellular hypertrophy. All features were more prominent at the junctional zone.


CONCLUSIONS
Smooth muscle cells from uteri with adenomyosis are ultrastructurally different from smooth muscle cells of normal uteri. These distinct features suggest a possible effect on myometrial contractility, together with hypertrophy.
Mehasseb
Mohamed Khairy
MK
Reproductive Sciences Section, Department of Cancer Studies and Molecular Medicine, Robert Kilpatrick Clinical Sciences Building, University of Leicester, Leicester LE2 7LX, United Kingdom. mkm7@le.ac.uk
Bell
Stephen Charles
SC
Pringle
James Howard
JH
Habiba
Marwan A
MA
D000328:Adult; D016022:Case-Control Studies; D004715:Endometriosis / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D008953:Models, Anatomic; D009215:Myometrium / Q000473:pathology* / Q000502:physiology / Q000503:physiopathology / Q000648:ultrastructure*; D016037:Single-Blind Method; D014590:Uterine Contraction / Q000502:physiology*; D014591:Uterine Diseases / Q000473:pathology* / Q000503:physiopathology