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ADENOMYOSIS

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Definition

 

  1. extension of areas of endometrial glands and stroma into the myometrium 
  2. also known as ìendometriosis internaî endometrium often remains unresponsive to ovarian hormones uterine wall may be diffusely involved

Incidence 

 

  1. 15% of females > 35 years old
  2. 20-40% of hysterectomy specimens
  3. older parous age group 40-50 years (in contrast to endometriosis)

Symptoms

 

  1. menorrhagia
  2. dysmenorrhea (secondary)
  3. pelvic discomfort
  4. dyspareunia
  5. dyschezia

Diagnosis 

 

  1. uterus symmetrically bulky
  2. uterus size is rarely greater than 2-3 times normal
  3. Halban sign: tender, softened uterus on premenstrual bimanual
  4. definitive diagnosis made at time of pathological examination

Treatment

 

  1. iron supplements as necessary
  2. D&C to rule out other pathology
  3. analgesics/NSAIDs
  4. low dose danazol 100-200 mg daily for 4 months
  5. GnRH agonists
  6. hysterectomy
ADENOMYOSIS ADENOMYOSIS Reviewed by Radiology Madeeasy on August 19, 2010 Rating: 5
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