title: Characteristics indicating adenomyosis coexisting with leiomyomas: a case-control study.
abstract: BACKGROUND
  Adenomyosis is rarely diagnosed before hysterectomy and commonly coexists with uterine leiomyomas. The objective of this study was to identify distinct features of a concurrent diagnosis of adenomyosis in women with uterine leiomyomas.
  
  
  METHODS
  We conducted a case-control study of women undergoing hysterectomy with a histologic diagnosis of both adenomyosis and leiomyomas and women with uterine leiomyomas but no adenomyosis. A retrospective medical record review of hospital and ambulatory records was performed to ascertain sociodemographic and anthropometric variables, as well as to confirm intraoperative and pathologic findings.
  
  
  RESULTS
  Our study sample comprised 255 patients, 85 women with adenomyosis and leiomyomas and 170 women with only leiomyomas. In multivariable logistic regression analyses, women with adenomyosis and leiomyomas were more likely to have more pelvic pain [odds ratio (OR) 3.4, 95% confidence interval (CI) 1.8-6.4], have less fibroid burden (OR per doubling in fibroid size 0.6, 95% CI 0.5-0.8), were more likely to be parous (OR 3.8, 95% CI 1.4-10.5) and have lower body mass index (OR per 5 unit increase in BMI 0.8, 95% CI 0.6-1.0) when compared with women with leiomyomas alone.
  
  
  CONCLUSIONS
  Women undergoing hysterectomy with both adenomyosis and leiomyomas have a number of different clinical features compared with women with only leiomyomas at the time of hysterectomy. Women with substantial pain despite a smaller fibroid burden may be more likely to have concomitant adenomyosis.
authors.affiliation: Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Mayo Clinic, 200 First St., SW, Rochester, MN 55905, USA. andrei.taran@med.ovgu.de
authors.forename: F Andrei
authors.initials: FA
authors.lastname: Taran
authors.forename: Amy L
authors.initials: AL
authors.lastname: Weaver
authors.forename: Charles C
authors.initials: CC
authors.lastname: Coddington
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Stewart
mesh_terms: D000328:Adult; D015992:Body Mass Index; D016022:Case-Control Studies; D004715:Endometriosis / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007889:Leiomyoma / Q000150:complications* / Q000601:surgery; D008875:Middle Aged; D016017:Odds Ratio; D017699:Pelvic Pain / Q000150:complications / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D014594:Uterine Neoplasms / Q000150:complications* / Q000601:surgery