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1
Devlieger, R. "Uterine adenomyosis in the infertility clinic." Human Reproduction Update 9, no. 2 (2003): 139–47. http://dx.doi.org/10.1093/humupd/dmg010.
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Raimondo, Diego, Lucia Lazzeri, Antonio Raffone, et al. "Sonographic Assessment of Uterine Biometry for the Diagnosis of Diffuse Adenomyosis in a Tertiary Outpatient Clinic." Journal of Personalized Medicine 12, no. 10 (2022): 1572. http://dx.doi.org/10.3390/jpm12101572.
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Background: to compare several uterine biometric parameters at transvaginal ultrasound (TVUS) between adenomyosis and non-adenomyosis uteri and evaluate their role for the diagnosis of diffuse adenomyosis. Methods: prospective observational study conducted between the 1 February 2022 and the 30 April 2022. In this case, 56 patients with TVUS diagnosis of adenomyosis were included. A 1:1 ratio age and parity-matched group of non-adenomyosis patients was selected. We compared sonographic uterine biometric parameters (longitudinal (LD), anteroposterior (APD) and transverse (TD) diameters, volume, simple and complex diameter ratios) and investigated their diagnostic performance. Results: all sonographic parameters were significantly different between the study groups, except for TD/(LD+APD). Optimal cut-off values of APD and LD/APD showed the best sensitivity and specificity. APD diameter equal or superior to 39.5 mm (95% CI, 36.2–42.8) had sensitivity of 0.70 (95% CI, 0.57–0.80), specificity of 0.71 (95% CI, 0.59–0.82) and accuracy of 0.75 (95% CI, 0.66–0.84). LD/APD equal or inferior to 2.05 (95% CI, 1.96–2.13) showed sensitivity and specificity of 0.70 (95% CI, 0.57–0.80) each and accuracy of 0.72 (95% CI, 0.62–0.81). Conclusions: several biometric uterine parameters at TVUS in fertile-aged women were statistically different between adenomyosis and non-adenomyosis uteri, though their optimal cut-off values showed low accuracy in diagnosing adenomyosis.
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Abdurakhmanova, S.I., and M.M. Rizaeva. "ANALYSIS OF THE GROWTH OF COMPLICATIONS OF UTERINE FIBROIDS AND ADENOMYOSIS IN POSTCOVID WOMEN." Journal of reproductive health and uro-nephrology research 3, no. 4 (2022): 4. https://doi.org/10.5281/zenodo.7418205.
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In gynecology, the most common diseases include uterine fibroids and adenomyosis. We can observe a significant increase in the detection of uterine fibroids and adenomyosis and their complications after the coronavirus pandemic. The study was conducted in the gynecology department of the III multidisciplinary clinic of TMA for the period 2018 – 2022, the medical histories of patients admitted to inpatient treatment for uterine fibroids and adenomyosis were studied.
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Biasioli, Anna, Matilde Degano, Stefano Restaino, et al. "Innovative Ultrasound Criteria for the Diagnosis of Adenomyosis and Correlation with Symptoms: A Retrospective Re-Evaluation." Biomedicines 12, no. 2 (2024): 463. http://dx.doi.org/10.3390/biomedicines12020463.
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The 2022 Delphi revision of the MUSA (Morphological Uterus Sonographic Assessment) criteria for the ultrasound diagnosis of adenomyosis divides the ultrasound signs for diagnosis into direct and indirect ones, considering the presence of at least one direct sign as a mandatory criterion. This study aimed to reclassify the patients referred to the Pelvic Pain specialist outpatient clinic of the Gynecological Clinic of Udine according to the new criteria, evaluating the number of overdiagnoses and the possible correlation between the direct and indirect signs and the patients’ symptoms. 62 patients affected by adenomyosis were retrospectively recruited. The patients were then re-evaluated by ultrasound and clinically. At least one direct sign of adenomyosis was found in 52 patients, while 16% of the population examined did not present any. There was no statistically significant difference between patients presenting direct signs and those presenting none for the symptoms considered. According to the new criteria, 16% of the patients examined were not affected by adenomyosis; applying the new consensus to symptomatic patients could increase false negatives. In a population of symptomatic patients, the diagnosis of adenomyosis is still highly probable even without direct ultrasound signs, given the clinical symptoms and having ruled out other causes of such symptoms.
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Stewart, Chelsea E., Mario E. Castellanos, Samantha P. Nadella, Rachel Eliason, Pooja Doehrman, and Ashley Gubbels. "Prevalence of histologically confirmed adenomyosis in a chronic pelvic pain cohort." Journal of Endometriosis and Pelvic Pain Disorders 15, no. 2 (2023): 58–63. http://dx.doi.org/10.1177/22840265231180676.
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Introduction: We aimed to determine the prevalence of pathology confirmed adenomyosis in women with chronic pelvic pain (CPP) who underwent surgical management with total hysterectomy, and to identify associated risk factors and demographic variables. Methods: This is a retrospective cohort study involving 1186 patients treated in a CPP-specialty clinic who underwent surgical management with hysterectomy between January 2010 and December 2021. Results: About 532/1186 (44.9%) of the cohort were diagnosed with adenomyosis on pathology following total hysterectomy. The average age of patients with adenomyosis was older than those without adenomyosis [41 years vs 38 years ( p < 0.001)]. There were no statistically significant differences in symptoms of menstrual bleeding, pelvic pain, dysmenorrhea, or dyspareunia. Those with adenomyosis were more likely to be Hispanic ( p < 0.001), have a history of pregnancy ( p < 0.001), and have chronic cervicitis ( p = 0.037). Uterine weight was significantly higher in the group with adenomyosis ( p = 0.033) especially when excluding leiomyoma ( p = 0.006). Discussion: The prevalence of adenomyosis on surgical pathology in a CPP cohort was higher than that reported for the general population. Uterine weights are higher in adenomyosis, even when controlling for leiomyoma. Classically attributed symptoms of adenomyosis were not useful predictors for the disease.
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Yaramareddy, Swapna, Siyonu Kumari Sardena, Nom Kumar Naik Bhukya, and Tulasi Ram Naik Menavath. "Fertility sparing treatment in an infertile patient with severe adenomyosis and a uterine fibroid: a case report." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 12, no. 5 (2023): 1510–12. http://dx.doi.org/10.18203/2320-1770.ijrcog20231254.
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Adenomyosis and uterine leiomyoma are benign lesions of the myometrium. Adenomyosis is a myometrial lesion characterised by the presence of ectopic endometrium with or without hyperplasia of the surrounding myometrium. Uterine fibroids, also called leiomyomas or myomas, are benign tumours that arise from the smooth muscle of the uterus. A 33-year-old nulliparous woman attended the clinic with primary infertility for 18 years. She was diagnosed with severe adenomyosis and uterine fibroids. She conceived successfully after undergoing in vitro fertilization (IVF) and a downregulated frozen embryo transfer (FET). Adenomyosis is a common cause of primary and secondary dysmenorrhea associated with infertility in young, nulliparous women. Fertility preservation is the primary goal in this population. Medical management is essential, and a properly downregulated and planned FET is the treatment of choice.
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Usta, Taner A., Tolga Karacan, Ulviye Hanli, Elif Cansu, and Engin Oral. "Hysteroscopic management of a juvenile cystic adenomyosis." Journal of Endometriosis and Pelvic Pain Disorders 10, no. 2 (2018): 123. http://dx.doi.org/10.1177/2284026518778793.
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Introduction: Hysteroscopic management of juvenile cystic adenomyosis on a virgin patient with non-touch technique. Description: Juvenile cystic adenomyosis of uterus is a cyst which is surrounded by myometrium and inside of this cyst is filled with hemorrhagic fluid. A 23-year-old virgin patient admitted to endometriosis outpatient clinic. The patient complained of dysmenorrhea, chronic pelvic pain, and abnormal uterine bleeding. A submucosal adenomyotic cyst was, sized 40 mm approximately, determined at posterior wall of uterus by transrectal ultrasonography. She received daily 2 mg dienogest (Visanne®) for 6 months. At the end of 6 months of treatment, the cyst size was still 35 mm. Hysteroscopy was performed with the use of the non-touch technique (vaginoscopic approach). A rigid 2.9-mm hysteroscope with a 12° oblique lens and an outer sheath diameter of 4 mm was used. When the cystic wall was ruptured by bipolar instrument, a chocolate-colored fluid was drained. The operation lasted 10 min. Her postoperative course was uncomplicated. Postoperatively, two dose of leuprolide acetate 11.25 mg (Lucrin depot®—3M; Abbot, Istanbul, Turkey) was prescribed (6 months total). On her sixth month, there was no cyst on transrectal ultrasonography examination. The patient did not exhibit any symptoms. Conclusions: Because the disease affects adolescent girls, fertility issues should be kept in mind during the workup and when operating on these patients. Hysteroscopy is a mini-invasive, safe, and effective option for the treatment of juvenile cystic adenomyosis.
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Prudnikov, P. M. "Role of clinical-anamnestic data in adenomyosis development at the present stage." HEALTH OF WOMAN, no. 4(120) (May 30, 2017): 54–56. http://dx.doi.org/10.15574/hw.2017.120.54.
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The objective: to study a role of clinical-anamnestic data in development and an adenomyosis current at the present stage. Patients and methods. Еxamination of 110 patients, from which 60 – patients with an adenomyosis of different degree of activity and prevalence – the main group was conducted. Depending on degree of expression of the main clinical implications, characteristic for the adenomyosis, all studied patients with an adenomyosis (n=60) conditionally were divided into 2 clinical subgroups: 1.1 – the subgroup was made by 38 patients with clinically "active" adenomyosis; 1.2 a subgroup – 22 patients with clinically "inactive" adenomyosis. The control group was made by 50 patients of genesial and premenopausa age without adenomyosis Results. As a result of the analysis of preliminary diagnoses at pre-hospital stage at patients with an adenomyosis their appreciable heterogeneity was taped. So, from 60 patients at 50% this diagnosis was made correctly, at 18.7% the adenomyosis was mistakenly taken for a hysteromyoma, at 11.7% – for hyperplasia and polyps an endometrium, at 6.7% – for dysfunctional uterine bleedings; at 3.3% – for cystoadenoma an ovary. 10.0% of patients a long time were surveyed and treated at the neuropathologist, the gastroenterologist, the therapist with suspicion on disk hernia, osteochondrosis, colitis, adherent process and so forth Conclusin. On the basis of clinical-anamnestic yielded and results of gynecologic inspection the adenomyosis was suspected at 48 patients, from them is confirmed – in 28 cases. The share of false positive results made 41%. At the same time from 60 patients with the confirmed adenomyosis, in the clinical diagnosis this pathology was taken out at 31. Thus, the share of false-negative results made 48%. Sensitivity of a method – 51.7%, specificity – 59%. The received results need to be considered at early diagnostics and adenomyosis forecasting. Key words: adenomyosis, clinic, anamnesis, diagnostics.
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Sendetskiy, Serhij. "Clinicalandanamnestic features of adenomyosis and combined pathology of uterus." Perinatology and reproductology: from research to practice 4, no. 4-1 (2025): 89–94. https://doi.org/10.52705/2788-6190-2024-04.1-13.
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The objective: to learn a role of clinical-and-anamnestic information in development and motion of adenomyosis on the modern stage.Materials and methods. An inspection was conducted 110 patients. A basic group was made by 60 patients, patients on adenomyosis of different degree of activity and prevalence. Depending on the degree of expressed of basic clinical displays, characteristic for adenomyosis, all investigational patients from adenomyosis (n=60) de bene esse parted on two clinical sub-groups: 1.1 – 38 patients from clinically «active» adenomyosis; 1.2 – 22 patients from clinically «nonactive» adenomyosis. A control group was made by 50 patients reproductive and premenopausal age without adenomyosis.Results.As a result of analysis of previous diagnoses on the prehospital stage for patients on adenomyosis was found out considerable heterogeneity diagnosed. From 60 patients in 30 women (50%) this diagnosis was put correctly, in 11 women (18,3%) of adenomyosis by mistake was accepted for a uterine fibroids, in 7 (11,7%) – for hyperplasia and endometrial polyps, in 4 (6,7%) – after dysfunctional uterine bleeding, in 2 (3,3%) – at ovarian cystadenoma. 6 women (9%) of patients were examined and treatment for a neurologist, gastroenterologist, internist with suspicion on hernia of disk, osteochondrosis, colitis long time, adhesive process and others like that.Conclusions. On the basis of clinical-and-anamnestic information and results of gynaecological inspection of adenomyosis it was suspected in 48 patients, it is confirmed from them – in 28. Part of false positive results was 41%. However from 60 patients with confirmed adenomyosis in a clinical diagnosis this pathology was taken away in 31. Thus, part of false negative results was 48%. Test-sensitivity – 51,7%, specificity – 59%. The got results must be taken into account during the conducting of early diagnostics and prognostication of adenomyosis. Keywords: adenomyosis, combined pathology of uterus, clinic, anamnesis, diagnostics
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Leshchova, Olga. "The women of the different agerelated groups have clinical aspects of adenomyosis." Perinatology and reproductology: from research to practice 4, no. 2 (2024): 64–69. https://doi.org/10.52705/2788-6190-2024-02-10.
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The objective: study of modern clinical aspects of adenomyosis. Materials and methods. An inspection was conducted 170 patients, from what 120 are patients of adenomyosis of different degree of activity and prevalence - basic group. A control group was made by 50 patients reproductive and premenopausal age without adenomyosis, which was added hysteгectomy with subsequent pathomorphological research of body of uterus concerning pelvic organ prolapse. To the complex of methods of researches were included clinical, laboratory, instrumental, morphological and statistical. Results. As a result of analysis of previous diagnoses on the prehospital stage for the patients of adenomyosis was discovered them considerable heterogeneity. From 120 patients in 49% this diagnosis was put correctly, in 18% adenomyosis by mistake was accepted for a hysteromyoma, in 11% – for hyperplasia and endometrial polyps, in 7% – after dysfunctional uterine bleeding; in 3% - at a ovarian cystadenoma. 9% patients long time inspected and treated oneself for a neurologist, gastroenterologist, internist with suspicion on hernia of disk, osteochondrosis, colitis, adhesive process and others like that. On the basis of clinical-and-anamnestic information and results of gynaecological inspection of adenomyosis was suspected in 95 patients, from them confirmed - in 56 cases. A part of pseudo-positive results was 41%. At the same time from 120 patients with confirmed adenomyosis, in a clinical diagnosis this pathology was taken away in 62, that part of pseudo-negative results was 48%, test-sensitivity – 51,7% and specificity – 59%.Conclusions. The got results specify in the presence of a few forms of this pathology, which must be taken into account in clinical to practice. The effective estimation of the got clinical results specifies on the necessity of improvement of existent algorithm of diagnostic and treatment-and-prophylactic measures for patients from adenomyosis.Keywords: adenomyosis, clinic, different age.
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Zhang, Yiqun, Lu Xue, Chunlian Zhang, and Jianying Zhou. "Evaluation of the Application Effect of Contrast-Enhanced Ultrasound Image Technology Based on Three-Dimensional Image Fusion Algorithm in the Diagnosis of Adenomyosis." Scientific Programming 2021 (August 28, 2021): 1–6. http://dx.doi.org/10.1155/2021/2896752.
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In this paper, the effect of ultrasound images based on a 3-dimensional image fusion algorithm in the diagnosis of adenomyosis was evaluated. 88 patients with adenomyosis who were treated in the hospital from February 2019 to May 2020 were selected as the research subjects. They were rolled into localized type (Group A), with 40 cases, and diffuse type (Group B), with 48 cases. At the same time, 45 women of normal childbearing age who underwent physical examination in the outpatient clinic were rolled into the control group (Group C). Three-dimensional ultrasound scans of the uterus were performed on all patients, to observe the enhancement methods and characteristics. Then, the image characteristics of adenomyosis were studied through the time-intensity curve (TIC). Arise time ATs of three groups of patients were not different greatly ( P > 0.05 ). It was found that the enhancement method, enhancement uniformity, and enhancement level of ultrasound scan in Groups A and B were significantly different from Group C ( P < 0.05 ). In contrast with Group C, the rise time (RT) of the ultrasound scan of the two groups was less, the time-to-peak (TTP) was faster, and the image maximum (IMAX) was higher ( P < 0.05 ). What is more, contrast-enhanced ultrasonic (CEUS) detection in patients with adenomyosis showed centrality and nonuniform high enhancement. Besides, less RT, faster TTP, and higher IMAX than the normal population can be the key evidence for the clinical diagnosis of adenomyosis. In conclusion, according to the blood supply characteristics of adenomyosis and other gynecological diseases, the enhancement method and enhancement time of ultrasound images are significantly different. TIC can reflect the hemodynamic difference between the lesion and the normal ones. Therefore, the CEUS based on the three-dimensional image fusion algorithm can be applied to the image diagnosis of adenomyosis.
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Kadam, Nikit, Somia Khalid, and Kanna Jayaprakasan. "How Reproducible Are the Ultrasound Features of Adenomyosis Defined by the Revised MUSA Consensus?" Journal of Clinical Medicine 14, no. 2 (2025): 456. https://doi.org/10.3390/jcm14020456.
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Background/Objectives: The aim of this study is to assess the inter- and intra-observer reproducibility of the identification of direct and indirect ultrasonographic features of adenomyosis as defined by the revised Morphological Uterus Sonographic Assessment (MUSA) consensus (2022). Methods: A cohort of 74 women, aged 18 to 45, were recruited from the recurrent miscarriage and general gynaecology clinic at a university-based fertility centre. All the participants underwent 2D and 3D transvaginal Ultrasound scan (TVS) examination in the late follicular and early luteal phase. Conventional grey scale and power Doppler image volumes were acquired and stored. Subsequently, the stored 3D ultrasound images were independently re-evaluated offline by the two observers for the direct and indirect features of adenomyosis as outlined by the revised MUSA group. The intra- and the inter-observer reproducibility was estimated using Cohen’s Kappa coefficient. Results: The intra- and interobserver reproducibility (K −0.27, 95% CI 0.06–0.48 and K 0.13, 95% CI −0.10–0.37, respectively) for at least one direct feature of adenomyosis was only modest. Amongst the individual direct features, the interobserver variability of identifying myometrial cysts was fair (K 0.21, 95% CI −0.00–0.42), whereas the intra-observer variability was moderate (K 0.44, 95% CI 0.26–0.63). While hyperechogenic islands identification achieved a fair level of intra- (K 0.31, 95% CI 0.09–0.53) and interobserver (K 0.24, 95% CI 0.01–0.47) agreement, the reproducibility of reporting sub-endometrial lines/buds was fair for the intra-observer (K 0.22, 95% CI −0.02 0.47) and poor for the interobserver (K 0.00, 95% CI −0.20–0.19). The interobserver agreement for indirect features varied from poor to moderate, while the intra-observer agreement ranged between poor to good. Conclusions: The reporting of adenomyosis using direct features suggested by the revised MUSA group consensus showed only modest interobserver and intra-observer agreement. The definitions of ultrasound features for adenomyosis need further refining to enhance the reliability of diagnosis criteria of adenomyosis.
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Du, Xiaoxin, Zhihui Cai, and Liwei Yan. "Current Status of the Diagnosis and Treatment of Adenomyosis." International Journal of General Practice Nursing 2, no. 2 (2024): 20–26. http://dx.doi.org/10.26689/ijgpn.v2i2.7249.
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Adenomyosis refers to the endometrial glands and mesenchyme that invade the myometrium through the basal layer, and under the action of hormones, repeated bleeding, myofibrous connective tissue hyperplasia formed by diffuse or limited lesions. It is a common disease in women of childbearing age and is more common in women over 40 years of age with menstruation. In recent years, the age of onset of the disease tends to be younger, which may be related to the various uterine surgical operations in clinical work, such as abortion, childbirth, curettage, chronic endometritis, and so on. The mechanism of the disease is currently thought to be due to the invasion of the basal endometrium into the myometrium for growth, but the ectopic endometrium is immature, has reactive changes to estrogen, and is insensitive to progesterone. Its main symptoms are increased menstrual flow, dysmenorrhea, and low fertility, which seriously affect the quality of life of patients. Among them, the incidence of excessive menstrual flow is 40%–50% and the incidence of dysmenorrhea is 15%–30%. There are numerous treatments available for adenomyosis aimed at reducing menstrual flow, relieving dysmenorrhea, and improving fertility. A brief review of the various treatments available for adenomyosis in the clinic is as follows.
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Akdan, Enes, Neşe Yücel, and Fikriye Işıl Adıgüzel. "The frequency of structural causes (PALM) according to FIGO PALM-COEIN classification in patients undergoing hysterectomy for abnormal uterine bleeding." Journal of Medicine and Palliative Care 5, no. 3 (2024): 172–76. http://dx.doi.org/10.47582/jompac.1483113.
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Aims: We aimed to determine the frequency of the PALM group in the FIGO PALM-COEIN system of patients who were operated for AUB, and to evaluate and analyze our data in our clinic. Methods: In a retrospective study, data were obtained for nonpregnant women aged 18–55 years who underwent hysterectomy for AUB at a center in Turkey in 2017-2022. The patients were retrospectively classified according to the PALM-COEIN system. Results: A total of 847 women were included. Leiomyoma was the most common pathology result in only 377 (44.5%) patients. The second most common pathology result was adenomyosis and leiomyoma coexistence in 132 (15.6%) patients. The third most common pathology result was 62 (7.3%) adenomyosis. Conclusion: In addition to the combined use of FİGO AUB system 1 and 2 in AUB, the notation grouping may be useful for clinicians in the management of AUB.
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Ahkubekova, Nelly K., Anatoly T. Tereshin, and Angela E. Bestaeva. "Correction of psychoemotional and vascular-autonomic dysfunction with patients suffering from endometrial disease under the influence of complex radon, laser, and drug treatment." Russian Journal of Physiotherapy, Balneology and Rehabilitation 18, no. 3 (2021): 161–65. http://dx.doi.org/10.17816/1681-3456-2019-18-3-161-165.
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The research objective is to develop a program to correct psycho-emotional and vascular-autonomic dysfunction with patients suffering from adenomyosis using complex radon, laser and drug treatment.
 Material and methods. There were 100 women with adenomyosis complicated by psycho-emotional and vascular-autonomic dysfunction from the age of 23 up to 37 years old who underwent treatment at a branch of Pyatigorsk Clinic of North Caucasian Federal Scientific and Clinical Centre of Federal Medical and Biological Agency of Russia. The patients were divided into 2 groups by a randomized method: the main group received radon, laser and drug therapy with Melaxen, the group of comparison received radon and laser therapy.
 Results. A comparative analysis showed the expediency of including adaptogens in the complex of sanatorium-and-spa treatment of patients with endometrial disease: the improvement of clinical symptoms in the main group compared to the group of comparison was more frequent by 1.36 times; normalization of vegetative management in the main group occurred with 72% of the patients compared to 52% in the group of comparison; in the main group the decrease in the intensity of anxious disorders was 2.64 times (p 0.01), against 1.46 times in the group of comparison (p 0.05); normalization of concentration of peptide and steroid hormones in blood serum in the main group was with 64% of the patients versus 42% in the group of comparison.
 Conclusion. Inclusion of Melaxen in the complex of traditional sanatorium-and-spa treatment of patients with adenomyosis (radon and laser therapy) provides significant improvement of neuroendocrine system, psycho-emotional, vegetative-vascular status.
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Likhacheva, V. V., A. G. Markdorf, L. G. Bazhenova, A. E. Vlasenko, and S. V. Shramko. "Evaluation of the influence of clinical risk factors on the performance of extracorporal fertilization programs." Bulletin of Siberian Medicine 17, no. 2 (2018): 49–59. http://dx.doi.org/10.20538/1682-0363-2018-2-49-59.
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Purpose of the study. To assess the influence of main clinical risk factors on the effectiveness of the in vitro fertilization (IVF) program.Materials and methods. The study included 3,969 IVF programs conducted in the “Medica” clinic of the “Mother and Child” group of companies in Novokuznetsk for 2010–2015. The inclusion criterion was the availability of information on the results of the procedure conducted.Results.The structure of the considered risk factors was identified, their key features were identified: the majority of women who underwent IVF procedure were under the age of 34, inclusive, more than half of all procedures were performed at the first attempt. The main causes of female infertility were: tubal factor, including those associated with chronic endometritis, polycystic ovary syndrome, external genital endometriosis and adenomyosis. In a number of cases, as a concomitant gynecological disease, uterine fibroids have been extirpated, which is not the main cause of infertility, but the presence of which can influence the effectiveness of IVF programs. Statistically significantly more often, fibroids were found in adenomyosis and tubal factors associated with chronic endometritis. A quantitative assessment of the degree of influence of the considered risk factors on the effectiveness of IVF programs was considered, and the influence of both individual factors and their combination was considered.Conclusion.The main factors statistically significantly increasing the risk of a negative outcome of the program are: the age of a woman over 30; repeated attempt at the age of up to 30 years inclusive (in comparison with the first attempt); tubular factor associated with chronic endometritis; presence of uterine fibroids in the tubular factor associated with chronic endometritis; The presence of fibroids in the tubular factor, complicated by adenomyosis.
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Uema, Cecilia Raquel L. M., André Luiz Mota da Costa, and Stefanie Vanessa Santos. "Cystic endometrial hyperplasia in african pygmy hedgehog (Atelerix albiventris) – case report." Clínica Veterinária XXV, no. 146 (2020): 52–60. http://dx.doi.org/10.46958/rcv.2020.xxv.n.146.p.52-60.
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A 2 year old female african pygmy hedgehog (Atelerix albiventris) was presented at a private clinic with persistent hematuria. Abdominal ultrasound identified suggestive changes of uterus enlargement, indicating its surgical removal. Anesthesia was accomplished with isoflurane via chamber induction and was maintained via mask. Ovariohysterectomy was performed and tissue fragments were submitted to histopathologic evaluation. For postoperative treatment, meloxicam, enrofloxacin and dipyrone were used. Microscopy revealed moderate uterine squamous metaplasia, cystic endometrial pseudocarcinomatous hyperplasia (CEH), and moderate uterine adenomyosis. The knowledge of these animals’ reproduction morphophysiology is essential, not only by the demand as pets in the clinical routine, as well as in the advances of comparative pathology.
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М., Б. Запорожченко, В. Сидоренко А., and Ю. Парубина Д. "Concomitant endometriosis and leiomyoma in women of reproductive age." REPRODUCTIVE ENDOCRINOLOGY, no. 36 (September 14, 2017): 24–30. https://doi.org/10.18370/2309-4117.2017.36.24-30.
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Endometriosis and leiomyoma commonly co-exist inside one uterus. Specialized surgical centers report detection frequency of comorbid endometriosis during surgery or laparoscopy that varies from 20 to 87% in patients with symptomatic fibroids. In authors practice the histological study of surgery samples from patients diagnosed with symptomatic fibroids (113 hysterectomies) revealed concomitant endometriosis in 26.5% cases. Clinical and morphological analysis showed that in patients with multiply fibroids, large volumes or submucous myomas comorbid adenomyosis doesn’t interfere significantly with the clinic course. But in cases of small-size solitary intramural or subserosis fibroids the clinic of symptomatic myomas is determined by the comorbid adenomyosis of diffuse-nodular or diffuse-lesion forms and 2–3 stages. Thus, endometriosis associated with leiomyomas causes more severe course of comorbidity. Patients with symptomatic fibroids are exposed to higher risk of endometriosis development, which must be kept in mind when planning the surgery treatment. Authors propose to enhance laparoscopic myomectomy with target revision of pelvis to reveal possible endometriosis, because laparoscopy provides the best opportunity to visualization of endometriosis lesions. The choice of pharmacotherapy of concomitant uterine pathology is limited. Gonadotropin-releasing hormone agonists is the only currently available group of drugs that labeled both for the treatment of endometriosis and fibroids. Selective progesterone-receptor modulator ulipristal acetate due to its unique antiproliferative and selective proapoptotic effect on the leiomyomas cellular component is very promising in the uterine-sparing therapy of myomas. In addition, it has pharmacodynamic effects on the endometrium, including antiproliferative effects that may contribute to the treatment of endometriosis. Clinical trial of ulipristal on this indication is ongoing (NCT02213081). For the present, in the absence of approved algorithms for the treatment of co-morbid pathology, the individual approach with combining preparations of different classes is relevant.
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Н., Ф. Захаренко, В. Коваленко Н. та П. Маноляк И. "Clinical case report: сonservative treatment of nodular adenomyosis". Reproductive Endocrinology, № 40 (30 квітня 2018): 44–48. https://doi.org/10.18370/2309-4117.2018.40.44-48.
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The article describes the clinical case of the nodular form of adenomyosis, first detected in a patient at the age of 16 years after another appeal to a gynecologist in connection with pronounced prolonged dysmenorrhea with ultrasound of a small pelvis. After the diagnosis of “Nodular form of adenomyosis”, the patient received 6 injections of triptorelin acetate 3.62 mg, resulting in an adenomyosis node decreased in size from 72 x 68 mm to 31 x 29 mm. Taking into account the developed side effects (aches in bones, hot flushes, weakness, tachycardia), therapy with triptorelin was discontinued. Clinical efficacy persisted for 6 months, after which painful menstruation resumed. Two years later, the patient was urgently transferred to the gynecological department of the Kyiv City Clinical Hospital No. 9 with severe manifestations of dysmenorrhea. With ultrasound of the pelvic organs, an endometrioid node in the uterus measuring 50 x 46 mm was found. The patient was recommended receiving Visanne (dienogest) in a dose of 2 mg, which she took 1 year and 10 months, being under constant supervision of the clinic’s specialists. The unauthorized break in treatment, which the patient explained with good health, provoked the resumption of painful symptoms. Visanne was continued for 2 years, as a result of which the endometrioid node decreased to 21.0 x 16.7 mm. In April 2017, in connection with the patient’s marriage and the desire to become pregnant, the reception of the dienogest was canceled. It is proposed to take a plant complex of antiproliferative action containing indole-3-carbinol 200 mg and green tea extract 82 mg. After 8 months, the patient was diagnosed with a pregnancy at 4 weeks, against which the adenomyosis node decreased to 18.1 x 11.1 mm. The results of the first two ultrasound screenings of the fetus in the gestation period of 13 and 18 weeks are described. There were no deviations in fetal development, and the endometriosis focus in the uterus was not clearly visualized at the first screening. The importance of the problem of secondary dysmenorrhea on the background of endometriosis, the establishment of a timely diagnosis and the choice of the right treatment tactics on which the future reproductive health of a teenage girl directly depends.
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Naftalin, J., W. Hoo, K. Pateman, D. Mavrelos, T. Holland, and D. Jurkovic. "How common is adenomyosis? A prospective study of prevalence using transvaginal ultrasound in a gynaecology clinic." Human Reproduction 27, no. 12 (2012): 3432–39. http://dx.doi.org/10.1093/humrep/des332.
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Kandyba, L. I., I. M. Sykal, V. M. Olkhovska, and M. P. Sokol. "ISTHMOCELE: ETIOLOGY, CLINIC, DIAGNOSIS AND TREATMENT (Literature review)." International Medical Journal, no. 1 (February 14, 2021): 52–55. http://dx.doi.org/10.37436/2308-5274-2021-1-9.
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Modern obstetrics is characterized with a loyal approach to surgical delivery, which has significantly affected the activity of maternity hospitals: the number of complications in childbirth from both the mother and fetus has decreased. The formed scar on the uterus is determined differently when examining the women in the postoperative period. Isthmocele is a hypogenic area in the myometrium within the site of postoperative scar in the form of a "niche", diverticulum or sac after cesarean section. It can lead to the development of diseases: abnormal uterine bleeding, dysmenorrhea, chronic pelvic pain, dyspareunia, infertility, adenomyosis, bladder dysfunction, as well as be the cause of ectopic pregnancy, uterine rupture, abnormalities in the placenta attachment of. Risk factors for isthmocele include low uterine incisions, a history of cervical removal, cervical dilatation of more than 5 cm, more than five hours of delivery, etc. For the first time the diagnosis of "isthmocele" is made at ultrasonic research, more often transvaginal one. The diagnosis is confirmed by hysteroscopy or constructive surgery. An important criterion for ismocele is the degree of deficiency, i.e. the ratio between the the biometry thickness on the scar and adjacent to the scar the myometrium area. Depending on the woman's reproductive plans, conservative or surgical treatment of isthmocele is recommended, using autologous stem cells to regenerate muscle tissue. Conservative treatment involves taking oral contraceptives. Surgical treatment includes the imposition of a two−row single−wing suture. The use of stem cells in the postoperative period allows a rise in the frequency of pregnancies in women with a scar on the uterus in the case of the isthmocele formation. Key words: isthmocele, cesarean section, myometrium, autocells.
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Budak, Hıdır, Rezan Buğday, Mehmet Şükrü Budak, Ahmet Yalınkaya, Adnan Budak, and Talip Gül. "Pre- and Postoperative Evaluation of Operated Myoma Uteri Patients: a 5-Year Tertiary Care Experience." Aegean Journal of Obstetrics and Gynecology 1, no. 1 (2019): 8–12. http://dx.doi.org/10.46328/aejog.v1i1.12.
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Introduction: This study aims to evaluate the pre- and postoperative outcomes of myomas operated in a tertiary clinic.
 Method: We retrospectively evaluated data from a total of 378 cases operated for myomas between January 2014 and December 2018 in the Dicle University Medical Faculty Obstetrics and Gynecology Clinic. 
 Results: There were 169 cases of abdominal myomectomy (44.7%), 156 cases of total abdominal hysterectomy (41.3%), 15 cases of laparoscopic myomectomy (4%), 13 cases of total laparoscopic hysterectomy (3.4%), 12 cases of myomectomy during cesarean delivery (3.2%), 9 cases of hysteroscopic myomectomy (2.4%), and 4 cases of vaginal myomectomy (1.1%). Pathology results revealed 341 cases of leiomyoma (88.2%), 32 cases of concomitant leiomyoma and adenomyosis (8.4%), and 13 cases of STUMP (3.3%). There were 5 cases of intraoperative bowel injury, 1 case of bladder injury, and 1 case of postoperative wound infection.
 Conclusion: Myomas can be surgically treated with satisfactory outcomes and low complication rates. The preferred surgical treatment will majorly depend on the patient's fertility expectations.
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Khodjaeva, Zarina Alikhanovna, and Djuraevna Muratova Nigora. "Features of clinical and laboratory parameters of adenomyosis combined with endometrioid ovarian cysts." Journal of reproductive health and uro-nephrology research 3, no. 4 (2022): 4. https://doi.org/10.5281/zenodo.7420829.
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The most common diseases among women of reproductive age include fibroids, adenomyosis and endometrioid ovarian cysts. The aim of the study was to determine the clinical and laboratory parameters of adenomyosis combined with endometrioid ovarian cysts in young women. We examined 80 women of reproductive age with adenomyosis and endometriosis of the ovaries. The average age of the examined patients was 25.4±0.14 years. All patients underwent hormonal, ultrasound and Doppler methods of examination. The results of the studies showed that 70% of the examined patients reported bleeding from the genital tract of varying intensity, and 30% complained of the absence of pregnancy. A change in the hormonal status was revealed, so the level of testosterone was increased by 3.5 times, 17-Oh progesterone was increased by an average of 5 times, the level of prolactin was increased in 35% of patients by 1.7 times. Dopplerometry revealed endometrial hyperplasia, adenomatous foci were visualized as anechoic inclusions with fuzzy edges, and the absence of a capsule around the adenomatous focus, the presence of single color signals along the periphery and the absence of blood flow inside. As a result of the treatment, fertility was restored in 27.2% of group 1 women, and in 60% of cases in group 2 women during the first year.
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Morelli, Michele, Roberta Venturella, Rita Mocciaro, Daniela Lico, and Fulvio Zullo. "An Unusual Extremely Distant Noncommunicating Uterine Horn with Myoma and Adenomyosis Treated with Laparoscopic Hemihysterectomy." Case Reports in Obstetrics and Gynecology 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/160291.
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A 41-year-old woman referred to us with dysmenorrhea and severe pelvic pain although she was previously submitted to right laparotomic adnexectomy for ovarian endometrioma and to a subsequent operative laparoscopy for pelvic adhesions. After ultrasound examination, the patient underwent diagnostic hysteroscopy and operative laparoscopy which confirmed the clinic suspect of an unicornuate uterus. However, it was very unusual to see an extremely distanced right horn, without communication with uterus, without adnexa, and with a small myoma belonging to it. Moreover, omentum and bowel were attached to fundus of right horn and thick adhesions fixed it to rectum and right pelvic wall. Therefore, identification of anatomical structures was difficult, as it was extremely arduous to isolate the ureter, which was involved inside the adhesions surrounding the right uterine horn. Nevertheless, laparoscopic right hemihysterectomy was successfully performed and right horn was sent to our pathologist who recognized hypotrophic endometrium and adenomyosis.
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Dr., Nida Fatima Dr. Israr Khan Dr. Hafsa Liaqat. "PATHOLOGICAL AND CLINICAL FACTORS LEADING TO HYSTERECTOMIES." INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES 05, no. 05 (2018): 4620–24. https://doi.org/10.5281/zenodo.1257658.
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<strong><em>Objective</em></strong><em>: To evaluate the pattern and frequency of </em><em>premalignant, malignant and benign lesions in </em><em>hystrectomized uteri and execute clinic-pathological investigation.</em> <strong><em>SETTING: </em></strong><em>collection of various </em><em>hysterectomy samples from </em><em>Nishtar Hospital Multan</em><em> was carried out. These specimens were studied in the </em><em>histopathology departments of these medical universities. Duration of the study was from </em><em>January</em><em> 2016 to December 2017.</em> <strong><em>Methods:</em></strong><em>100 cases were selected who were undergoing </em><em>hysterectomy. They were selected randomly for the detailed study. Afterwards, </em><em>clinic-pathological examination was carried out. Most of the females undergoing hysterectomy were aged from 25</em><em>-75 years. Two separate forms were prepared to note down the clinical details and record histopathological</em><em> results. Preservation of the samples was executed in 10 percent formalin. They were comprehensively examined accordingly. Process of Representative blocks for paraffin embedding was performed.</em> <strong><em>Results: </em></strong><em>The most frequent complaint was abnormal menstrual flow. 43.06 ±</em><em>7.34 years was mean age of the patients.</em><em> From the randomized study of one hundred cases, the most common findings were related to </em><em>endometrial diseases</em><em> (</em><em>67 percent of the patients). Adenomyosis was found in 47 percent of the cases whereas leiomyoma was noted in 32 percent of the cases.</em><em> Invasive cervical carcinoma was in 03 percent and </em><em>cervical intraepithelial neoplastic changes were found as 04 percent of the cases</em><em>.</em> <strong><em>Conclusion:</em></strong><em>To sum up the findings,</em><em> benign uterine lesions were frequent which encompasses </em><em>adenomyosis, endometrial hyperplasia and leiomyoma. These are equally seen in females in Multan whose ages are above or below of 40 years. However, with two exceptions of </em><em>invasive</em><em> cervical carcinoma and endometrial carcinoma which were mostly noted in the women aged above 40 years.</em> <strong>Key Words: </strong><em>Cervical</em><em> Carcinoma, Endometrial Hyperplasia, Hysterectomy, Endometrial carcinoma and Leiomyoma.</em>
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Chermak, Ihor I., Volodymyr I. Chermak, Roman M. Zakordonets, Olori Sharon Oboghene, and Anatolii Ya Senchuk. "New approaches to the treatment of endometrial pathology in patients with extragenital diseases." Biomedical update, no. 2 (November 24, 2021): 22–27. http://dx.doi.org/10.52739/bio-up.2.2021.22-27.
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With purpose to increase efficiency and decrease frequencies of complications after treatment of endo- and myometrium pathology in patients of the perimenopausal period with extragenital pathology this study has been conducted. Different conducted clinic-laboratory, instrumental and pathology examination were performed. 130 patients of the perimenopausal period from somatic pathology (46-60 years) were divided into representative groups. The main group consisted of 100 patients who suffered from endometrium hyperplasia and adenomyosis. The control group included 30 healthy women without pathology of endoand myometrium.
 Patients of the main group, depending on the applied treatment-and-prophylactic approach, were divided into two subgroups. Group I included 50 women who underwent hysteroscopy and intrauterine cryosurgery, magnesium supplements, and thromboembolic complications (TEC) prevention measures. Patients of the II group (50 patients) underwent hysteroscopy and treatment and prevention measures following the recommendations of the Protocol of the Ministry of Health of Ukraine (№ 676 of 31.12.2004). T
 he effectiveness of the proposed approach to diagnosis, minimally invasive treatment (hysteroscopy and intrauterine cryosurgery), and prevention of TEC and inflammatory complications of endo pathology- and myometrium in patients of the perimenopausal period with extragenital pathology, according to the clinic-laboratory and cytomorphological examination, the results of ultrasound was 82.0 %, prevention of TEC and inflammatory complications — 100 % cases. According to generally accepted approaches, the effectiveness of treatment was 36.0 %, TEC prevention — 96.0 %, prevention of inflammatory complications — 78.0 %.
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Gkrozou, Fani, Anastasia Vatopoulou, Chara Skentou, and Minas Paschopoulos. "Diagnosis and Treatment of Adenomyosis with Office Hysteroscopy—A Narrative Review of Literature." Diagnostics 13, no. 13 (2023): 2182. http://dx.doi.org/10.3390/diagnostics13132182.
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Introduction: Adenomyosis is a common chronic disease in women of reproductive age, characterised by the presence of ectopic endometrial tissue within myometrium. Even though adenomyosis presents with chronic pelvic pain, menorrhagia or abnormal uterine bleeding, dysmenorrhoea, and dyspareunia and is often recognised after hysterectomies. However, the development of ultrasonography and magnetic resonance imaging has improved the pre-operative diagnosis of the disease. Hysteroscopy provides information in real time from the uterine cavity and the offers the possibility of obtaining direct biopsies. Material and Methods: The literature was searched via Pubmed and Embase with the following headings: diagnosis of adenomyosis or adenomyoma and office hysteroscopy, hysteroscopy findings of adenomyosis or adenomyoma, treatment of adenomyosis or adenomyoma with office hysteroscopy. Results: The literature showed that hysteroscopy can identify superficial adenomyosis. There are a variety of hysteroscopic images that can be connected with the disease. New equipment like the spirotome has been used to access deeper layers of myometrium and obtain biopsies under direct vision from the adenomyotic areas. Different methods of treatment have been also described, like enucleation of focal superficial adenomyoma, coagulation, evacuation of cystic adenomyosis when the lesion is smaller than 1.5 cm, and resection of adenomyotic nodules in case of bigger lesions (>1.5 cm). Diffuse superficial adenomyosis is also managed by resection. Conclusions: Hysteroscopy has revolutionised the approach to adenomyosis. It is a useful tool in assessing mainly superficial adenomyosis. The role of hysteroscopy in surgical management of adenomyosis need to be confirmed with further studies.
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Marhenriyanto, Wahyuridistia, and Dedy Hendry. "Perbandingan Skala Nyeri Pasien Kista Endometriosis Dan Adenomiosis Sebelum Operasi, Setelah Operasi Dan Setelah Pemberian GNRH Analog." JOURNAL OBGIN EMAS 4, no. 1 (2020): 35–47. http://dx.doi.org/10.25077/aoj.4.1.35-47.2020.
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Background: Endometriosis is the growth of the epithelium and endometrial glands outside the uterine cavity. In endometriosis there is a process of neurogenesis and angiogenesis. The degree of endometriosis pain depends on the depth of endometrial implant infiltration in nerve fibers and / or neurogenesis. Operative action and postoperative hormone therapy are the main choices for preventing recurrence and reducing pain complaints.Purpose: to determine the comparison of pain scales of patients with endometriosis before surgery, after surgery and after administration of GnRH analogues.Method: This study was an observational analytic with a retrospective cohort design in the Obstetrics and Gynecology Clinic of RSUP Dr. M. Djamil Padang in June 2017 to January 2018. The sample size were of 35 people with inclusion and exclusion criteria. The inclusion criteria were the diagnosis of endometriosis (endometriosis cysts and adenomyosis) from ultrasonography and anatomical pathology, had surgery and received analogue GnRH injection three times. Exclusion criteria were not proven endometriosis, hysterectomy surgery, using analgesics and not following analogue GnRH injection procedures. The pain scale is assessed by the Wong-Baker Faces Pain Rating Scale. The pain scale is assessed during menstruation before surgery, first menstruation after surgery and first menstruation after three analogues of GnRH injections. Data analysis using SPSS version 22, where univariate analysis is used to see the characteristics of respondents and bivariate analysis using Wilcoxon Test. Statistical test results were significant if p <0.05.Result: Based on the Wilcoxon statistical test results obtained p value = 0.0001 (p value <0.05) which can be concluded that there is a significant reduction in the pain of endometriosis of patients after surgery compared to before surgery.Conclusion: There was a significant decrease in pain in endometriosis patients before surgery.Keywords: Endometriosis, Adenomyosis, Pain Scale, GnRH anaologist
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Rusda, Muhammad, Andri Sipahutar, and Andrina Yunita Murni Rambe. "Application of International Endometrial Tumor Analysis in Abnormal Uterine Bleeding: A Case Report." Open Access Macedonian Journal of Medical Sciences 10, T7 (2022): 7–11. http://dx.doi.org/10.3889/oamjms.2022.9236.
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BACKGROUND: Abnormal uterine bleeding (AUB) is one of the clinical symptoms found in malignant conditions where the incidence of newly diagnosed cancers reached 100,000 cases in Europe in 2012 with an incidence of around 14.7/100,000 women. The International Endometrial Tumor Analysis (IETA) group, formed in Chicago in 2008, published a consensus stating how to examine and measure the endometrium. CASE REPORT: Mrs. M, 49 years old, came to Gynecology Clinic of USU Hospital on February 22, 2021, at 13.00 WIB with the complaints of prolonged menstruation for 2 months with a volume of >10 times changing pads. Menstrual pain was found. Low back pain was found. A history of bleeding between menstrual cycles was found. On ultrasound examination, anteflexed uterus was found with size of 6.95 × 4.2 × 3.85 cm, thickness of the endometrium: 1.64 cm and concluded as AUB-M (thickening of the endometrium). Then, the patient is diagnosed with AUB-M (thickening of the endometrium) and is planned to undergo a diagnostic curettage. Anatomical pathology results showed a complex hyperplasia endometrium without atypia cells. Acute AUB is defined as bleeding profusely so that prompt treatment is needed to prevent blood loss. Ultrasound examination is performed to assess the size, shape of the uterus, the presence of fibroids, polyps, adenomyosis, and uterine anomalies such as uterine didelphys, sometimes polycystic ovaries are also found. Endometrial biopsy can detect more than 90% of cancers. The pathology of the endometrium can diagnose endometrial cancer or determine the likelihood of cancer. These investigative modalities can assist in the diagnosis of endometrial polyps, adenomyosis, leiomyomas, uterine anomalies, and endometrial thickening associated with hyperplasia and malignancy. Curettage is considered to relieve ongoing menorrhagia. According to the SOGC, administration of nonsteroidal anti-inflammatory drugs can inhibit cyclo-oxygenase and reduce levels of endometrial prostaglandins. DISCUSSION: Acute AUB is defined as bleeding profusely so that prompt treatment is needed to prevent blood loss. Ultrasound examination is performed to assess the size, shape of the uterus, the presence of fibroids, polyps, adenomyosis, and uterine anomalies such as uterine didelphys, sometimes polycystic ovaries are also found. Endometrial biopsy can detect more than 90% of cancers. The pathology of the endometrium can diagnose endometrial cancer or determine the likelihood of cancer. These investigative modalities can assist in the diagnosis of endometrial polyps, adenomyosis, leiomyomas, uterine anomalies, and endometrial thickening associated with hyperplasia and malignancy. Curettage is considered to relieve ongoing menorrhagia. According to the SOGC, administration of nonsteroidal anti-inflammatory drugs can inhibit cyclo-oxygenase and reduce levels of endometrial prostaglandins. CONCLUSION: According to IETA, the vascular pattern in the endometrium is reported to be associated with the presence or absence of a “dominant vessel” or other specific pattern. Endometrial thickness is the maximum measurement in the sagittal plane. The accompanying ultrasound provides the measurement of endometrial thickness in the absence of intracavity fluid; the endometrium should be measured where it appears thickest. If intracavity pathology is present, total thickness of endometrium including the lesion should be recorded. Anatomic pathology by curettage is required in women with abnormal bleeding; histological evaluation of the endometrium may identify infectious or neoplastic lesions such as endometrial hyperplasia or cancer.
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Amit, Kumar, Kumari Jyoti, and Kumar Sujeet. "Assess Endometrial Biopsy Audit and its Clinico-Pathological Correlation in Patients with Abnormal Uterine Bleeding in Bihar Region." International Journal of Current Pharmaceutical Review and Research 15, no. 11 (2023): 208–11. https://doi.org/10.5281/zenodo.11551390.
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AbstractAim: The aim of the present study was to assess endometrial Biopsy Audit and its Clinico-PathologicalCorrelation in Patients with Abnormal Uterine Bleeding in Bihar regionMethods: The present study was conducted in the Department of Pathology over a period of 12 months. 200cases were selected in the study.Results: In the study majority 45% were in the age group 41 to 50 years. In the study 5% were Nulliparous andmajority were in para 2 (51%). In the study majority of subjects had Heavy menstrual bleeding (48%). In thestudy clinically, 48% were diagnosed to have fibroid, 25% had Adenomyosis. In the study 45% hadProliferative, 28% had Secretory, 12% had Endometrial hyperplasia and 8% had Endometrial carcinoma.Conclusion: Abnormal uterine bleeding is a common diagnosis and the commonest presentation ismenorrhagia. Histopathological examination of the endometrium showed a wide spectrum of pathologicalchanges ranging from normal endometrium to malignancy thus necessitating endometrial sampling as animportant diagnostic tool in the management of abnormal uterine bleeding. Accurate analysis of endometrialsampling is the key to effective therapy and optimal outcome.
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Amarnath, Kumar Nayak, Debbarma Dipti, Rajnish Kumar, and Prakash Anand Anand. "Assessment of Endometrial Biopsy in Patients with Abnormal Uterine Bleeding: An Observational Study." International Journal of Current Pharmaceutical Review and Research 15, no. 10 (2023): 201–4. https://doi.org/10.5281/zenodo.11622597.
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AbstractAim: The aim of the present study was to assess endometrial Biopsy Audit and its Clinico-PathologicalCorrelation in Patients with Abnormal Uterine Bleeding in Bihar regionMethods: The present study was conducted in the Department of Pathology from February 2023 to June 2023.100 cases were selected in the study.Results: In the study majority 44% were in the age group 41 to 50 years. In the study 5% were Nulliparous andmajority were in para 2 (52%). In the study majority of subjects had Heavy menstrual bleeding (47%). In thestudy clinically, 46% were diagnosed to have fibroid, 24% had Adenomyosis. In the study 45% hadProliferative, 28% had Secretory, 12% had Endometrial hyperplasia and 8% had Endometrial carcinoma.Conclusion: Abnormal uterine bleeding is a common diagnosis and the commonest presentation ismenorrhagia. Histopathological examination of the endometrium showed a wide spectrum of pathologicalchanges ranging from normal endometrium to malignancy thus necessitating endometrial sampling as animportant diagnostic tool in the management of abnormal uterine bleeding. Accurate analysis of endometrialsampling is the key to effective therapy and optimal outcome.
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Zhang, Airong, Xiujuan Liu, Juan Wang, Kui Deng, and Jianghua Wang. "MiR-30c-5p Directly Targets MAPK1 to Regulate the Proliferation, Migration and Invasion of Adenomyotic Epithelial Cells in Adenomyosis." Twin Research and Human Genetics 24, no. 1 (2021): 22–28. http://dx.doi.org/10.1017/thg.2021.11.
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AbstractThe purpose of our study was to elucidate the functions of miR-30c-5p on adenomyosis for exploring novel treatment strategies. We first detected the expression of miR-30c-5p in clinical adenomyotic tissues and isolated endometrial cells from adenomyotic tissues. Next, gain and loss-of-function assays were performed to detect the effect of miR-30c-5p on adenomyotic endometrial cells. Further, luciferase assay and real-time polymerase chain reaction as well as western blot were conducted to investigate the potential target of miR-30c-5p; and transwell assay, wound-healing assay and CCK-8 assay were used to evaluate the effects of miR-30c-5p and its target on regulating biological functions of adenomyotic endometrial cells. Our results found that miR-30c-5p was down-regulated in both adenomyosis tissues and adenomyotic epithelial cells, which correlated with dysmenorrhea, longer duration of symptoms and more menstrual bleeding. Moreover, the overexpression of miR-30c-5p inhibited the proliferation, migration and invasion of adenomyotic epithelial cells, where miR-30c-5p knockdown had an opposite effect. Furthermore, we confirmed mitogen-activated protein kinase 1 (MAPK1) was one of the direct targets of miR-30c-5p, indicating its important role in miR-30c-5p-mediated suppression of proliferation, invasion and migration in adenomyotic epithelial cells. This study showed that the interaction of miR-30c-5p with MAPK1 can regulate the proliferation, invasion and migration in adenomyotic epithelial cells.
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Krut, Yu Ya, and N. A. Zemlyana. "Clinical-anamnestic and ELISA predictors of recurrence of endometrial hyperplastic processes in combination with uterine fibroids." Reproductive health of woman 5 (December 31, 2020): 48–52. http://dx.doi.org/10.30841/2708-8731.5.2021.224498.
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Endometrium hyperplastic processes (EHP) are characterized by high prevalence, high risk of malignancy and frequent recurrence.The objective: identify risk factors for recurrence in EHP in combination with uterine fibroids based on the study of clinical and anamnestic data and markers of oncogenesis.Materials and methods. The study examined 81 women with endometrial hyperplastic processes (34 women with simple endometrial hyperplasia without atypia and 47 women with complex endometrial hyperplasia without atypia), who were treated in the at the gynecological department of the “City Clinical Hospital No. 7” in Zaporizhia. Patients were divided into groups based on the presence of uterine fibroids (38 women without fibroids and 43 women with uterine fibroids). Patients underwent ultrasound examination on the MyLab50 device (Esaote, Italy) and video hysteroscopy (Karl Storz, Germany). Morphological examination was performed in the pathology department of the University Clinic of ZSMU. The level of markers of oncogenesis VEGF-A, Ki-67, APRIL, survinin and pPTEN in the serum was determined by ELISA assay using Elabscience reagents (USA). Statistical data processing was performed using statistical programs “Statistica 6.0 for Windows” (StatSoft Inc., № AXXR712D833214FAN5).Results. In the EHP group without uterine fibroids, recurrences were observed in 8 patients (21.5%) during the year. In women with EHP in combination with uterine fibroids during the year recurrences were observed in 13 patients (30.3%). In patients with EHP without concomitant uterine fibroids, reliable predictors of recurrence were the presence of adenomyosis (RR=4.58; CI=0.89–23.72; p<0.05), obesity (RR=7.0; CI=1,18–41,53; p<0,05), arterial hypertension (AH) (RR=6,0; CI=1,02–35,27; p<0,05), pathology of thyroid glands (RR=5,47; CI=1.04–28.89; p<0.05) and mammary gland pathology (RR=6.0; CI=1.02–35.27; p<0.05). In the presence of uterine fibroids, the reliable predictors of recurrence of EHP were the presence of adenomyosis (RR=4.50; CI=1.11–18.27; p<0.05), chronic endometritis (RR=4.40; CI=1.11–17.84; p<0.05), obesity (RR=7.39; CI=1.73–31.52; p<0.05), hypertension (RR=4.40; CI=1.11–17.48; p<0.05) and pathology of the mammary glands (RR=5.25; CI=1.28–21.57; p<0.05). Significant predictors of recurrence in women with EHP without uterine fibroids were elevated levels VEGF-A above 126 pg/ml (RR=12.0; CI=1.91–75.06; p<0.05), APRIL level greater than 36 pg/ml (RR=9.85; CI=1,61–60.24; p<0.05) and survinin more than 103 pg/ml (RR=15.0; CI=2.32–96.96; p<0.05). In patients with EHP in combination with uterine fibroids, a significant association with recurrence was associated with an increase in VEGF-A above 126.96 pg/ml (RR=10.95; CI=2.34–5.60; p<0.05) and APRIL levels greater than 41.36 pg/ml (RR=9.17; CI=1.99–42.04; p<0.05).Conclusions. With EHP without uterine fibroids during the year recurrences were observed in 21.5% of women, in the presence of uterine fibroids recurrences are found in 30.3% of women. The risks of recurrence of EHP in patients without uterine fibroids are increased in the presence of adenomyosis, hypertension, pathology of the mammary glands and thyroid gland. In women with uterine fibroids, the risk of recurrence of EHP is associated with the presence of adenomyosis, chronic endometritis, hypertension and breast pathology. Molecular-biological predictors of EHP recurrence in women without uterine fibroids were an increase in VEGF-A above 126 pg/ml, APRIL levels above 36 pg/ml and survinin above 103 pg/ml. The presence of uterine fibroids at the level of VEGF-A predictors above 126.96 pg/ml and the level of APRIL above 41.36 pg/ml is associated with an increased risk of recurrence of EHP.
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Yu., Ya. Krut, and A. Zemlyana N. "Clinical-anamnestic and ELISA predictors of recurrence of endometrial hyperplastic processes in combination with uterine fibroids." Reproductive health of woman 5 (December 31, 2020): 48–52. https://doi.org/10.30841/2708-8731.5.2021.224498.
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Endometrium hyperplastic processes (EHP) are characterized by high prevalence, high risk of malignancy and frequent recurrence. <strong>The objective:</strong> identify risk factors for recurrence in EHP in combination with uterine fibroids based on the study of clinical and anamnestic data and markers of oncogenesis. <strong>Materials and methods.</strong> The study examined 81 women with endometrial hyperplastic processes (34 women with simple endometrial hyperplasia without atypia and 47 women with complex endometrial hyperplasia without atypia), who were treated in the at the gynecological department of the “City Clinical Hospital No. 7” in Zaporizhia. Patients were divided into groups based on the presence of uterine fibroids (38 women without fibroids and 43 women with uterine fibroids). Patients underwent ultrasound examination on the MyLab50 device (Esaote, Italy) and video hysteroscopy (Karl Storz, Germany). Morphological examination was performed in the pathology department of the University Clinic of ZSMU. The level of markers of oncogenesis VEGF-A, Ki-67, APRIL, survinin and pPTEN in the serum was determined by ELISA assay using Elabscience reagents (USA). Statistical data processing was performed using statistical programs “Statistica 6.0 for Windows” (StatSoft Inc., № AXXR712D833214FAN5). <strong>Results.</strong> In the EHP group without uterine fibroids, recurrences were observed in 8 patients (21.5%) during the year. In women with EHP in combination with uterine fibroids during the year recurrences were observed in 13 patients (30.3%). In patients with EHP without concomitant uterine fibroids, reliable predictors of recurrence were the presence of adenomyosis (RR=4.58; CI=0.89–23.72; p<0.05), obesity (RR=7.0; CI=1,18–41,53; p<0,05), arterial hypertension (AH) (RR=6,0; CI=1,02–35,27; p<0,05), pathology of thyroid glands (RR=5,47; CI=1.04–28.89; p<0.05) and mammary gland pathology (RR=6.0; CI=1.02–35.27; p<0.05). In the presence of uterine fibroids, the reliable predictors of recurrence of EHP were the presence of adenomyosis (RR=4.50; CI=1.11–18.27; p<0.05), chronic endometritis (RR=4.40; CI=1.11–17.84; p<0.05), obesity (RR=7.39; CI=1.73–31.52; p<0.05), hypertension (RR=4.40; CI=1.11–17.48; p<0.05) and pathology of the mammary glands (RR=5.25; CI=1.28–21.57; p<0.05). Significant predictors of recurrence in women with EHP without uterine fibroids were elevated levels VEGF-A above 126 pg/ml (RR=12.0; CI=1.91–75.06; p<0.05), APRIL level greater than 36 pg/ml (RR=9.85; CI=1,61–60.24; p<0.05) and survinin more than 103 pg/ml (RR=15.0; CI=2.32–96.96; p<0.05). In patients with EHP in combination with uterine fibroids, a significant association with recurrence was associated with an increase in VEGF-A above 126.96 pg/ml (RR=10.95; CI=2.34–5.60; p<0.05) and APRIL levels greater than 41.36 pg/ml (RR=9.17; CI=1.99–42.04; p<0.05). <strong>Conclusions.</strong> With EHP without uterine fibroids during the year recurrences were observed in 21.5% of women, in the presence of uterine fibroids recurrences are found in 30.3% of women. The risks of recurrence of EHP in patients without uterine fibroids are increased in the presence of adenomyosis, hypertension, pathology of the mammary glands and thyroid gland. In women with uterine fibroids, the risk of recurrence of EHP is associated with the presence of adenomyosis, chronic endometritis, hypertension and breast pathology. Molecular-biological predictors of EHP recurrence in women without uterine fibroids were an increase in VEGF-A above 126 pg/ml, APRIL levels above 36 pg/ml and survinin above 103 pg/ml. The presence of uterine fibroids at the level of VEGF-A predictors above 126.96 pg/ml and the level of APRIL above 41.36 pg/ml is associated with an increased risk of recurrence of EHP.
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Löffelmann, Anna C., Alena Hoerscher, Muhammad A. Riaz, Felix Zeppernick, Ivo Meinhold-Heerlein, and Lutz Konrad. "Claudin-10 Expression Is Increased in Endometriosis and Adenomyosis and Mislocalized in Ectopic Endometriosis." Diagnostics 12, no. 11 (2022): 2848. http://dx.doi.org/10.3390/diagnostics12112848.
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Claudins, as the major components of tight junctions, are crucial for epithelial cell-to-cell contacts. Recently, we showed that in endometriosis, the endometrial epithelial phenotype is highly conserved, with only minor alterations. For example, claudin-11 is strongly expressed; however, its localization in the endometriotic epithelial cells was impaired. In order to better understand the role of claudins in endometrial cell-to-cell contacts, we analyzed the tissue expression and localization of claudin-10 by immunohistochemistry analysis and two scoring systems. We used human tissue samples (n = 151) from the endometrium, endometriosis, and adenomyosis. We found a high abundance of claudin-10 in nearly all the endometrial (98%), endometriotic (98–99%), and adenomyotic (90–97%) glands, but no cycle-specific differences and no differences in the claudin-10 positive endometrial glands between cases with and without endometriosis. A significantly higher expression of claudin-10 was evident in the ectopic endometrium of deep-infiltrating (p < 0.01) and ovarian endometriosis (p < 0.001) and in adenomyosis in the cases with endometriosis (p ≤ 0.05). Interestingly, we observed a shift in claudin-10 from a predominant apical localization in the eutopic endometrium to a more pronounced basal/cytoplasmic localization in the ectopic endometria of all three endometriotic entities but not in adenomyosis. Significantly, despite the impaired endometriotic localization of claudin-10, the epithelial phenotype was retained. The significant differences in claudin-10 localization between the three endometriotic entities and adenomyosis, in conjunction with endometriosis, suggest that most of the aberrations occur after implantation and not before. The high similarity between the claudin-10 patterns in the eutopic endometrial and adenomyotic glands supports our recent conclusions that the endometrium is the main source of endometriosis and adenomyosis.
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Dembele, Mamadou, Alassane Kouma, Ilias Guindo, et al. "ULTRASOUND IN THE ETIOLOGICAL ASSESSMENT OF EMBRYONIC IMPLANTATION FAILURES AT THE FERTILIA MEDICAL CLINIC IN BAMAKO." International Journal of Advanced Research 11, no. 06 (2023): 1324–30. http://dx.doi.org/10.21474/ijar01/17196.
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Recurrent implantation failure refers to failure to achieve a clinical pregnancy after the transfer of at least four embryos in at least three fresh or frozen cycles in a woman under 40 years of age. Implantation failure can be a consequence of embryonic or uterine factors. Thorough investigations must be necessary to determine whether there is an embryonic or uterine cause. Various uterine pathologies, including fibroids, endometrial lesions, polyps, congenital anomalies and intrauterine adhesions, vascular parameters should be explored by ultrasound to aid in the diagnosis of the causes of embryo implantation failures [1]. Aims: - To describe the sonographic lesions likely to explain embryo implantation failures. - To determine the correlation between ultrasound lesions detected during our study and embryo implantation failures. Subjects And Methods: This was a cross-sectional, descriptive study concerning 165 women collected between January 2016 and January 2022 at the Fertilia medical clinic in Bamako. The study population consisted of consenting women in whom at least three unsuccessful attempts to transfer good quality fresh or frozen embryos were made. All of our patients underwent a biological assessment, but our study focused on the contribution of ultrasound. Ultrasounds were performed by endocavitary and suprapubic route with General Electric Voluson E8, Vivid 3 and Logic9 devices. Results: 165 women were recruited into our. The average age was 38 years with extremes ranging from 23 to 52 years. 86 patients or 52% were between 30 and 40 years old. 94 patients or 57% had made at least three unsuccessful attempts to transfer good quality embryos. 139 patients or 84.24% had at least one ultrasound anomaly. The most common pathologies were adenomyosis (30.3%), endometritis (13.94%), hydrosalpinx (4.24%), a high pulsatility index (12.12%), the presence of notch in one or both uterine arteries (7.27 %), polymyomatous uterus (26%), congenital malformation (1.21%), polyp (4.85%). Conclusion: Repeated embryo implantation failures are partly due to the embryo and partly to the uterus or its annexes. Ultrasound is a tool of choice in developing countries such as ours to diagnose the causes of these implantation failures and to allow infertile couples to procreate. We were able to highlight the relationships that exist between abnormalities detected on ultrasound and repeated embryo implantation failures.
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Gladenko, S. E., and A. A. Dovgan. "Clinical-endocrinological and echografical aspects of good-quality dysplasia of mammary glands at women of reproductive age." HEALTH OF WOMAN, no. 8(144) (October 31, 2019): 75–77. http://dx.doi.org/10.15574/hw.2019.144.75.
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The objective: to study modern clinical-endocrinologic and echografical aspects of good-quality dysplasia of mammary glands at women of reproductive age. Materials and methods. Were surveyed 90 patients aged from 22 till 45 years which are divided into 3 groups on 30 women: 1 group - group of control - the woman without pathology in mammary glands. The 2nd group included patients with diffuse form of good-quality dysplasia of mammary glands. The 3rd group was made by patients with a nodal form of a good-quality dysplasia of mammary glands. The complex the researches included clinical, echografical, endocrinologic and statistical methods. Results. Results of the conducted researches testify that it is possible to refer existence of chronic extragenital diseases, smoking, an early menarche to risk factors of development of a good-quality dysplasia of mammary glands, disturbances of a menstrual cycle, hysteromyoma and an adenomyosis, an artificial or spontaneous abortion. Disturbance of ratio of LG/FSG is characteristic for all patients with diseases of mammary glands. For these patients as the hypoprogesteronemia is characteristic. Disturbance of ratio of levels of Gonadotropinums in combination with hypoprogesteronomia can be referred to risk factors of development of good-quality dysplasia of mammary glands. Conclusion. The received results needs to be considered when developing algorithm of diagnostic and treatment-and-prophylactic actions. Key words: good-quality dysplasia of mammary glands, clinic, endocrinology, echography.
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Deryabina, Viktoriya A., Tatiana V. Brus, and Sarng S. Pyurveev. "Endometriosis and adenomyosis: common and disparate features." Pediatrician (St. Petersburg) 13, no. 5 (2022): 81–97. http://dx.doi.org/10.17816/ped13581-97.
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Endometriosis and adenomyosis are diseases of the gynecological profile, which are ectopic endometrioid tissue and have long been considered tangible manifestations of the process. Only recently have scientists begun to put forward a theory about the unequal origin of these pathologies. In endometriosis, the lining of the uterus extends beyond it, mainly to the ovaries, fallopian tubes, and bladder. With adenomyosis, the nodes grow into the muscular wall of her uterus and thicken. They do not go outside the uterus. Both conditions cause severe pain due to local inflammation, swelling and adhesions in the abdominal cavity. The only reliable way to identify the diagnosis of endometriosis is invasive exploratory laparoscopy with biopsy of tissue samples. In contrast, an enlarged uterus with adenomyotic nodules can be assessed even on routine examination, and on ultrasound or MRI they are visualized in the report. Obviously, despite the high frequency of pathophysiological and molecular mechanisms, endometriosis and adenomyosis has rare causes, clinics and effects on the reproductive system of the female body, which significantly reduces the risk and treatment of diseases.
 The review provides a comparative characteristic of endometriosis and adenomyosis in terms of prevalence, etiology, pathogenesis, clinical manifestations, effects on fertility and experimental modeling, obtained from domestic and foreign sources.
 Understanding the pathophysiology of adenomyosis and endometriosis opens up additional possibilities for diagnosis, prevention, and treatment. The development of new diagnostic methods based on modern high-tech methods allows us to assume a preclinical stage and identify the diagnosis, predict and carry out adequate treatment depending on the histological picture.
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Bashirov, E. V., V. A. Krutova, and I. I. Kutsenko. "Biomarkers of the type of recurrent uterine myoma-associated growth." Medical Herald of the South of Russia 12, no. 4 (2021): 6–11. http://dx.doi.org/10.21886/2219-8075-2021-12-4-6-11.
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Objective: To assess the diagnostic value of biomarkers: microbiological, molecular and biological, immunological biomarkers, characteristic of various types of recurrent myoma-associated growth.Materials and Methods: Seventy women of reproductive age with recurrent uterine myoma and its combination with adenomyosis after conservative treatment in the Clinic of Kuban State Medical University were examined. Methods: microbiological examination, sonography, Doppler sonography, histology, immunohistochemistry, morphometry.Results: The type of recurrent myoma-associated growth was proved to be dependent on molecular and biological characteristics of tumors, the presence of infection and blood perfusion. It was indicated that women with recurrence of myoma-associated growth of a “false” type were characterized by high rates of infections (the presence of reproductive losses, chronic inflammatory diseases of the pelvic organs) and significant bacterial contamination of the genital tract biotopes. Blood perfusion features were identified for true and “false” types of recurrent myoma-associated growth based on Doppler sonography data, which were consistent with features of tumor vessel morphometry. Analysis of uterine myoma histological types and their vascularization features showed correlation of forms with a high proliferative potential of a tumor on a molecular and cellular level to moderate and high expression of steroid hormone receptors in combination with Ki67, a significant diameter of the lumen of the vessels with the highest VI and VFI values.Conclusions: A comprehensive study of women with uterine hyperplasia determines the possibility of prediction of pathogenetic variants of recurrent myoma-associated tissue growth and adequate choice of treatment options and rehabilitation course.
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Hadiprajitno, Peter Ivan, and Sultana Faradz. "Genetic Counseling in a Couple with Primary Infertility." Journal of Biomedicine and Translational Research 8, no. 3 (2022): 149–54. http://dx.doi.org/10.14710/jbtr.v8i3.16179.
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Background: Couples unable to conceive and bear children could feel deep disappointment, often leading to depression. Infertility is one of the main reasons couples are not able to have children. Genetic counseling role in infertility ranges from explanation about possible genetic causes of infertility, pregnancy planning, and advice for treatment. Case Presentation: A couple with 16 years of infertility was referred to the genetic clinic at National Diponegoro Hospital. The 42 years old female had previous history of diabetes mellitus, obesity, and had treatment of epilepsy/seizure 15 years ago with routine carbamazepine therapy for 2 years, while her 42 years old husband had active hepatitis B infection for 15 years. This couple underwent insemination program twice and once completed In Vitro Fertilization (IVF), both management bearing no successful implantation or viable pregnancy. Recently, she underwent a laparoscopy procedure, which gave new diagnosis of endometriosis and adenomyosis. Chromosomal examination and Methylenetetrahydrofolate Reductase (MTHFR) C677T and A1298C alleles analysis were done in our laboratory. Both individuals carried normal karyotypes and MTHFR analysis was homozygote wild type allele. Currently, this couple has accepted their conditions. They still want to bear a child although she is at a crucial ageConclusion: Infertility is a challenging and comprehensive problem. As healthcare professionals, we encounter problems not only in diagnosis and management, but also psychological and emotional dilemma. Genetic counseling is needed to solve the problems and avoid patient’s psychological distress.
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Maoga, Jane B., Muhammad A. Riaz, Agnes N. Mwaura, et al. "Impaired Expression of Membrane Type-2 and Type-3 Matrix Metalloproteinases in Endometriosis but Not in Adenomyosis." Diagnostics 12, no. 4 (2022): 779. http://dx.doi.org/10.3390/diagnostics12040779.
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Matrix metalloproteinases (MMPs) play an important role in menstruation and endometriosis; however, the membrane-type matrix metalloproteinases (MT-MMPs) are not well studied in endometriosis and adenomyosis. We analyzed MT2-MMP (MMP15) and MT3-MMP (MMP16) in eutopic endometrium with and without endometriosis and with and without adenomyosis and ectopic endometrium of deep infiltrating endometriosis (DIE), peritoneal endometriosis (PE), and ovarian endometriosis (Ov) by immunohistochemistry. Preferential expression of both proteins was observed in the glandular and luminal epithelial cells of the eutopic endometrium of patients with and without endometriosis with a ~2.5-fold stronger expression of MT3-MMP compared to MT2-MMP. We did not observe any differences during menstrual cycling and in eutopic endometrium of patients with and without endometriosis. Similarly, eutopic endometrium and adenomyotic tissue with and without endometriosis showed similar protein levels of MT2-MMP and MT3-MMP. In contrast, MT2-MMP and MT3-MMP protein was decreased in ectopic compared to eutopic endometrium and adenomyosis. The similar expression of MT2-MMP and MT3-MMP in eutopic endometrium in patients with and without endometriosis in contrast to the impaired expression in ectopic endometrium suggests that alterations occur after and not before endometrial implantation possibly by distinct interactions with the different environments. The differential protein expression of MT2/3-MMP in adenomyosis compared to endometriosis might suggest a different pathogenesis pathway for the two diseases.
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Alkhamis, Areeb A., Basmah S. AlDeghaither, and Lateefa O. Aldakhil. "FIGO PALM–COEIN Classification of Abnormal Uterine Bleeding in Saudi Women." Saudi Journal of Medicine & Medical Sciences 12, no. 4 (2024): 314–18. http://dx.doi.org/10.4103/sjmms.sjmms_310_24.
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Abstract Background: Abnormal uterine bleeding (AUB) is a significant concern in women’s health. However, there is limited research on its prevalence and characteristics in Saudi Arabia. Objectives: To determine the prevalence of AUB in a gynecology outpatient setting in Saudi Arabia and to categorize the cases of AUB according to the FIGO classification. Methods: This retrospective study included all Saudi female patients who presented to the Obstetrics and Gynecology clinic at King Khalid University Hospital, Riyadh, Saudi Arabia, over a 2-year period, except those who were pregnant. Data regarding demographics, BMI, clinical symptoms, laboratory tests, ultrasound results, and histopathology findings was collected. Cases of AUB were classified using the FIGO PALM-COEIN system. Results: A total of 2724 patients were included, of which 44.6% had AUB. The most common presentations of AUB were irregular cycles (59.3%) and heavy bleeding (12.8%), and the most affected group was the reproductive age group (19-39 years). Obesity was identified as a significant risk factor. AUB-O (ovulatory disorder; functional cause) was the most prevalent (23%), followed by AUB-L (leiomyomas, 18%; structural cause) and AUB-P (polyps, 8.8%). Specific AUB patterns correlated with ultrasonographic findings, with heavy bleeding associated with polyps, adenomyosis, and leiomyomas. AUB patients had lower hemoglobin levels, indicating potential health impacts. Conclusions: The study found that nearly half of all women presenting with gynecological complaints in Riyadh, Saudi Arabia, have AUB. According to the FIGO classification, functional causes of AUB were more prevalent than structural causes. Further research is necessary to explore underlying causes of AUB and its long-term health implications.
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Alkatout, I., T. Becker, P. Nuhn, et al. "The first robotic-assisted hysterectomy below the bikini line with the Dexter robotic system™." Facts, Views and Vision in ObGyn 16, no. 1 (2024): 87–91. http://dx.doi.org/10.52054/fvvo.16.1.010.
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Background: Robotic-assisted hysterectomy (RAH) is a widely accepted minimally invasive approach for uterus removal. However, as RAH is typically performed in the umbilical region, it usually results in scars in cosmetically suboptimal locations. This is the first case of RAH with cervicosacropexy performed below the bikini line, using the new Dexter robotic system™. Objectives: The aim of this article is to show the surgical steps of the first RAH with cervicosacropexy performed below the bikini line with the new Dexter robotic system™ (Distalmotion), and furthermore assess the feasibility of this approach using this robotic platform. Materials and methods: A 43-year-old woman with uterine adenomyosis and recurrent uterine prolapse underwent a robotic-assisted subtotal hysterectomy with cervicosacropexy, performed below the bikini line, using the Dexter robotic system™, at the Clinic of Gynecology and Obstetrics at Universitätsklinikum Schleswig-Holstein (UKHS) in Kiel, Germany. Main outcome measures: Perioperative data, surgical approach specifics, objective, and subjective outcomes of this new approach. Results: The procedure was performed without intra-operative complications; estimated blood loss was 10 ml. Operative time was 150 minutes, console time 120 minutes, total docking time 6 minutes. Dexter performed as expected; no device-related issues or robotic arm collisions occurred. The patient did not require pain medication and was released on the second postoperative day. Conclusion: RAH performed below the bikini line using the Dexter robotic system™ is a feasible, safe, and adequate procedure. These initial results should be confirmed and further extensively refurbished with larger patient cohorts, and functional and psychological outcomes need further investigation.
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Kravchenko, E. N., and E. V. Lautenschleger. "Endometrial hyperplasia and endometrial polyps: clinical and anamnestic characteristics of women." Fundamental and Clinical Medicine 8, no. 4 (2024): 16–23. http://dx.doi.org/10.23946/2500-0764-2023-8-4-16-23.
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Aim. To study the clinical and anamnestic characteristics of patients with endometrial hyperplasia (EH) and endometrial polyps (PE).Material and Methods. a retrospective study was conducted, which included 267 sick women of reproductive and perimenopausal age who sought gynecological care at «Euromed» in 2022-23, who, before receiving the examination results, were diagnosed with N92 - heavy, frequent and irregular menstruation. Depending on the results of the pathomorphological examination, the patients were divided into 3 groups: group A included 89 patients with GE; group B – 99 women with PE; Group B (control) included 79 patients in whom endometrial pathology was excluded.Results. Among all women who came to the clinic with heavy menstrual bleeding, 33.3% had GE, 37.1% had PE, 29.6% had BUN-O ovulatory dysfunction. GE without atypia was detected in 72 (80.9%) cases of group A, GE with atypia – in 7 (19.1%), in group B PE was diagnosed in 91 (91.9%) cases, PE with atypia – in 28 (8.1%).In group B, in 22 (27.8%) cases, the endometrium was identified in the proliferation phase, in 57 (72.2%) cases, the endometrium was identified in the phase of incomplete secretion.Conclusion. Women with GE are characterized by early menarche, absence of pregnancies and childbirth during life associated with the woman’s choice, contraception, endocrine diseases, obesity, polycystic ovary syndrome, ovarian tumors, heavy bleeding with clots during menstruation, menstruation for more than 8 days, chronic iron deficiency anemia. Women with endometrial polyps are characterized by arterial hypertension, uterine fibroids, adenomyosis, infertility, dysmenorrhea, chronic endometritis, a history of cervicitis and vaginitis; clinical manifestations include intermenstrual bleeding.
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Frijlingh, M., R. A. de Leeuw, L. J. M. Juffermans, T. van den Bosch, and J. A. F. Huirne. "Visualisation of microvascular flow in benign uterine disorders: a pilot study of a new diagnostic technique." Facts, Views and Vision in ObGyn 15, no. 2 (2023): 115–22. http://dx.doi.org/10.52054/fvvo.15.2.072.
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Background: Uterine disorders have clear overlapping symptoms and ultrasound discrimination is not always easy. Accurately measuring vascularity is of diagnostic and prognostic value. Power Doppler is limited to imaging only the larger vessels. Assessment of the microvasculature requires advanced machine settings. Objectives: In this pilot study, we aimed to test the feasibility of microvascular flow imaging of benign uterine disorders. Material and Methods: Two experienced gynaecologists (JH, RL) randomly applied power Doppler and MV-flowTM mode during a single day, in ten patients each visiting the outpatient clinic. Images of eight patients were labelled with a diagnosis by the attending physicians and collected as coded data. Main outcome measures: Microvascular flow images of normal uterine architecture including the fallopian tube, and of benign disorders such as fibroids, adenomyosis, endometriosis and uterine niches were collected. For both Doppler techniques, qualitative descriptive evaluation of the vascular architecture and a quantitative vascular index of fibroids were provided. Finally, we evaluated the effect of the cardiac cycle. Results: All microvascular flow images showed more distinctive vascular structures than visible on power Doppler. Calculating a vascular index for fibroids on 2D MV-flowTM images was easily performed on-site. During the cardiac cycle a higher vascular index (VI 75.2) is obtained in systole as compared with diastole (VI 44.0). Conclusion: Microvascular flow imaging allowed detailed visualisation of the uterine vascular architecture and is easy to use. What is new? Microvascular flow imaging may be of added value for diagnosing uterine disorders, as well as for pre- and post-operative assessment of suited surgical techniques. Yet, validation with histology and clinical outcomes is required.
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KEPKEP, Necip, Coşkun ÖZSARAÇ, Suna ERKILIÇ, and Lügen CENGİZ. "Adenomyosis in 38 Hysterectomy Specimens." European Journal of Therapeutics 3, no. 2 (1992): 168–75. http://dx.doi.org/10.58600/eurjther.19920302-1053.
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Adenomyosis is the histopathological and clinical entity causes progressive seconder dysmenorrhea and menorrhagia in the mid aged parous women. Basal endometrium generally insensitive to ovarian hormo:ı;ı.es, lay within the myometrial layers. Adenomyosis was detected in 26 of 38 uteruses which were removed because of various indications in one year period in the Gynecological Oinic of the Medical School of Gaziantep University. Findings and clinics of adenomyosis were presented and discussed in the paper.
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Amin, Saira, Raham Bacha, Syed Muhammad Yousaf Farooq, et al. "Uterine Artery Doppler Indices in the Various Causes of Abnormal Uterine Bleeding Confirmed with Histopathology." Pakistan Journal of Medical and Health Sciences 16, no. 8 (2022): 466–68. http://dx.doi.org/10.53350/pjmhs22168466.
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Background: All disturbed pattern of bleeding which arises due to different reasons such as anovulation, pregnancy, uterine abnormalities and coagulopathies is termed as abnormal uterine bleeding (AUB). Abnormal uterine bleeding is present in many forms such as heavy bleeding, short menstrual cycle, excessive and heavy menstruation, uterine bleeding at irregular period, excessive and prolonged uterine bleeding. Abnormal uterine bleeding is mostly caused by benign findings such as endometrial hyperplasia or atrophy or benign polyps. Around 5–12% of Abnormal uterine bleeding results from Endometrial Cancer. Objective: Uterine artery Doppler indices in various causes of abnormal uterine bleeding confirmed with histopathology. Methodology: A Cross-sectional Analytical study was conducted at Shireen Ultrasound Clinic Peshawar, Pakistan. This study enrolled a purposive sample of 162 patients presenting with abnormal uterine bleeding with the age between 18 to 80 years. The examination was performed with Toshiba Nemio 20(Xario Prime with TVS Probe frequency range 7-14MHz) .The Resistive index(RI), Pulsatility index(PI), mean and standard deviation were calculated for the continuous variables. Results: A total of 162 patients were enrolled in our study. The mean age of patients was recorded 38±5 years. In this study, the histopathological findings were as follow, 8.6% adenomyosis,12.3% endometrial hyperplasia, 43.3% leiomyoma’s, 17.3% polyp, 2.5% endometrial carcinoma and 16% non-specific findings so the most common cause of abnormal uterine bleeding was leiomyoma’s with mean of Right Uterine artery (U-A) PI and RI was 3.33±1.23 and 0.83±0.03 respectively and left U-A PI and RI was 2.95±1.17 and 0.84±0.03 respectively while the least common cause was endometrial carcinoma with mean of Right U-A PI and RI was 2.54±1.08 and 0.52±0.01 respectively and of Left U-A PI and RI was 1.62±0.00 and 0.52±0.00 respectively. Conclusion: From our study we concluded that the uterine artery RI in endometrial carcinoma causing abnormal uterine bleeding is low and in benign condition like polyp, hyperplasia and fibroids is high. Keywords: Uterine bleeding, Carcinoma, Fibroids, Hyperplasia, Trans-vaginal ultrasound
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Kuru, Oguzhan, Ipek Betul Ozcivit Erkan, Cansu Turker Saricoban, Utku Akgor, Neslihan Gokmen Inan, and Sennur Ilvan. "The Role of Endometrial Sampling before Hysterectomy in Premenopausal Women with Abnormal Uterine Bleeding." Journal of Clinical Medicine 13, no. 13 (2024): 3709. http://dx.doi.org/10.3390/jcm13133709.
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Background/Objectives: An endometrial sampling is recommended for patients experiencing abnormal uterine bleeding above the age of 40 or 45. Valid risk prediction models are needed to accurately assess the risk of endometrial cancer and avoid an unnecessary endometrial biopsy in premenopausal women. We aimed to assess the necessity and usefulness of preoperative endometrial sampling by evaluating premenopausal women who underwent hysterectomy for abnormal uterine bleeding after preoperative endometrial sampling at our clinic. Methods: A retrospective analysis was conducted on 339 patients who underwent preoperative endometrial sampling and subsequently underwent hysterectomy due to abnormal uterine bleeding. Detailed gynecologic examinations, patient histories, and reports of endometrial sampling and hysterectomy were recorded. Cohen’s Kappa (κ) statistic was utilized to evaluate the concordance between histopathological results from an endometrial biopsy and hysterectomy. Results: The mean age of the cohort was 47 ± 4 years. Endometrial biopsies predominantly revealed benign findings, with 137 (40.4%) cases showing proliferative endometrium and 2 (0.6%) cases showing endometrial cancer. Following hysterectomy, final pathology indicated proliferative endometrium in 208 (61.4%) cases, with 7 (2.1%) cases showing endometrioid cancer. There was a statistically significant but low level of concordance between histopathological reports of endometrial biopsy and hysterectomy results (Kappa = 0.108; p < 0.001). Significant differences were observed only in the body mass index of patients based on hysterectomy results (p = 0.004). When demographic characteristics were compared with cancer incidence, smoking status and preoperative endometrial biopsy findings showed statistically significant differences (p = 0.042 and p = 0.010, respectively). Conclusions: The concordance between the pathological findings of a preoperative endometrial biopsy and hysterectomy is low. Body mass index is an important differentiating factor between benign histopathologic findings of endometrium and endometrial neoplasia. Moreover, adenomyosis was found to be associated with endometrial cancer cases. The current approach to premenopausal women with abnormal uterine bleeding, which includes a routine endometrial biopsy, warrants re-evaluation by international societies and experts.
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Rukhliada, N. N., and Y. V. Tsveliov. "Experience of surgical treatment of manifesting forms of adenomyosis." Journal of obstetrics and women's diseases 52, no. 3 (2003): 43–46. http://dx.doi.org/10.17816/jowd88969.
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One describes in this article the technique of performing surgeries with saved organs at manifested adenomyosis, one presents the treatment results of women with various clinico-morphological disease forms by means of different surgical methods.
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Moraru, Liviu, Melinda-Ildiko Mitranovici, Diana Maria Chiorean, et al. "Adenomyosis and Its Possible Malignancy: A Review of the Literature." Diagnostics 13, no. 11 (2023): 1883. http://dx.doi.org/10.3390/diagnostics13111883.
Full textAbstract:
Cancer arising from adenomyosis is very rare, with transformation occurring in only 1% of cases and in older individuals. Adenomyosis, endometriosis and cancers may share a common pathogenic mechanism that includes hormonal factors, genetic predisposition, growth factors, inflammation, immune system dysregulation, environmental factors and oxidative stress. Endometriosis and adenomyosis both exhibit malignant behaviour. The most common risk factor for malignant transformation is prolonged exposure to oestrogens. The golden standard for diagnosis is histopathology. Colman and Rosenthal emphasised the most important characteristics in adenomyosis-associated cancer. Kumar and Anderson emphasised the importance of demonstrating a transition between benign and malignant endometrial glands in cancer arising from adenomyosis. As it is very rare, it is difficult to standardize treatment. In this manuscript, we try to emphasize some aspects regarding the management strategy, as well as how heterogenous the studies from the literature are in terms of prognosis in both cancers that develop from adenomyosis or those that are only associated with adenomyosis. The pathogenic mechanisms of transformation remain unclear. As these types of cancer are so rare, there is no standardised treatment. A novel target in the diagnosis and treatment of gynaecological malignancies associated with adenomyosis is also being studied for the development of new therapeutic concepts.