Understanding adenomyosis: a case control study.
OBJECTIVE
To elucidate the clinical profile of adenomyosis by comparison with uterine leiomyomas.


METHODS
Retrospective case-control study.


METHODS
Academic medical center.


METHODS
The study comprised 76 women undergoing hysterectomy with adenomyosis and 152 women with uterine leiomyomas but no adenomyosis.


METHODS
Retrospective medical record review of hospital and ambulatory records.


METHODS
Comparison of women undergoing hysterectomy with a sole pathologic finding of adenomyosis and women with leiomyomas alone.


RESULTS
Adenomyosis was independently associated with younger age (41.1 years vs. 44.3 years), history of depression (57.1% vs. 24.7%), dysmenorrhea (65.7% vs. 42.3%), and pelvic pain (52.9% vs. 21.1%) in a multivariable unconditional logistic regression analysis compared with women with leiomyomas, where women from both groups had gynecologic symptoms. Furthermore, in a second multivariate model where all subjects had uteri weighing>150 g, women with adenomyosis were more likely to have a history of depression (52.6% vs. 22.2%) and endometriosis (26.3% vs. 2.8%) compared with women with leiomyomas.


CONCLUSIONS
Women undergoing hysterectomy with a histologic diagnosis of adenomyosis have a distinct symptomatology and medical history compared with women with leiomyomas. Better understanding of this disease is required to improve diagnosis and management.
Taran
F Andrei
FA
Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota.
Weaver
Amy L
AL
Division of Biostatistics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.
Coddington
Charles C
CC
Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota.
Stewart
Elizabeth A
EA
Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota. Electronic address: stewart.elizabeth@mayo.edu.
D000328:Adult; D000465:Algorithms; D016022:Case-Control Studies; D032882:Comprehension; D004715:Endometriosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007889:Leiomyoma / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D008499:Medical Records / Q000706:statistics & numerical data; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014591:Uterine Diseases / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000601:surgery