title: Uterine adenomyosis is associated with ultrastructural features of altered contractility in the inner myometrium.
abstract: 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.
authors.affiliation: 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
authors.forename: Mohamed Khairy
authors.initials: MK
authors.lastname: Mehasseb
authors.forename: Stephen Charles
authors.initials: SC
authors.lastname: Bell
authors.forename: James Howard
authors.initials: JH
authors.lastname: Pringle
authors.forename: Marwan A
authors.initials: MA
authors.lastname: Habiba
mesh_terms: 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