Adenomyosis

Epidemiology, risk factors, clinical phenotype and surgical and interventional alternatives to hysterectomy

F. A. Taran, Elizabeth A Stewart, S. Brucker

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Adenomyosis is an important clinical challenge in gynecology and healthcare economics; in its fully developed form, hysterectomy is often used to treat it in premenopausal and perimenopausal women. Symptoms of adenomyosis typically include menorrhagia, pelvic pain and dysmenorrhea. Moreover, adenomyosis and leiomyomas commonly coexist in the same uterus, and differentiating the symptoms for each pathological process can be problematic. Although it has been recognized for over a century, reliable epidemiological studies on this condition are limited, because only postoperative diagnoses were possible in the past. Minimally invasive surgical techniques (endometrial ablation/resection, myometrial excision/reduction, myometrial electrocoagulation, uterine artery ligation) have had limited success in the treatment of adenomyosis, and the reported data for these procedures have been obtained from case reports or small case series with only short follow-up times. However, newer techniques including uterine artery embolization (UAE) and magnetic resonance imaging guided focused ultrasound (MRgFUS) show promise in treating adenomyosis. The data is strongest for UAE; these studies have the largest patient cohorts. However, none of the UAE studies were randomized or controlled. Thus, despite the clinical importance of adenomyosis, there is little evidence on which to base treatment decisions. The objective of this review is to summarize the epidemiology, risk factors, clinical phenotype and to evaluate the accrued experience with surgical and interventional alternatives to hysterectomy.

Original languageEnglish (US)
Pages (from-to)924-931
Number of pages8
JournalGeburtshilfe und Frauenheilkunde
Volume73
Issue number9
DOIs
StatePublished - 2013

Fingerprint

Adenomyosis
Hysterectomy
Epidemiology
Uterine Artery Embolization
Phenotype
Endometrial Ablation Techniques
Menorrhagia
Uterine Artery
Dysmenorrhea
Electrocoagulation
Pelvic Pain
Leiomyoma
Pathologic Processes
Gynecology
Uterus
Ligation
Epidemiologic Studies
Economics
Magnetic Resonance Imaging
Delivery of Health Care

Keywords

  • adenomyosis
  • endometrial ablation
  • hysterectomy
  • magnetic resonance guided focused ultrasound
  • uterine artery embolization

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Maternity and Midwifery

Cite this

Adenomyosis : Epidemiology, risk factors, clinical phenotype and surgical and interventional alternatives to hysterectomy. / Taran, F. A.; Stewart, Elizabeth A; Brucker, S.

In: Geburtshilfe und Frauenheilkunde, Vol. 73, No. 9, 2013, p. 924-931.

Research output: Contribution to journalArticle

@article{1bbcd16b2e0e421b8f9046923d3ae835,
title = "Adenomyosis: Epidemiology, risk factors, clinical phenotype and surgical and interventional alternatives to hysterectomy",
abstract = "Adenomyosis is an important clinical challenge in gynecology and healthcare economics; in its fully developed form, hysterectomy is often used to treat it in premenopausal and perimenopausal women. Symptoms of adenomyosis typically include menorrhagia, pelvic pain and dysmenorrhea. Moreover, adenomyosis and leiomyomas commonly coexist in the same uterus, and differentiating the symptoms for each pathological process can be problematic. Although it has been recognized for over a century, reliable epidemiological studies on this condition are limited, because only postoperative diagnoses were possible in the past. Minimally invasive surgical techniques (endometrial ablation/resection, myometrial excision/reduction, myometrial electrocoagulation, uterine artery ligation) have had limited success in the treatment of adenomyosis, and the reported data for these procedures have been obtained from case reports or small case series with only short follow-up times. However, newer techniques including uterine artery embolization (UAE) and magnetic resonance imaging guided focused ultrasound (MRgFUS) show promise in treating adenomyosis. The data is strongest for UAE; these studies have the largest patient cohorts. However, none of the UAE studies were randomized or controlled. Thus, despite the clinical importance of adenomyosis, there is little evidence on which to base treatment decisions. The objective of this review is to summarize the epidemiology, risk factors, clinical phenotype and to evaluate the accrued experience with surgical and interventional alternatives to hysterectomy.",
keywords = "adenomyosis, endometrial ablation, hysterectomy, magnetic resonance guided focused ultrasound, uterine artery embolization",
author = "Taran, {F. A.} and Stewart, {Elizabeth A} and S. Brucker",
year = "2013",
doi = "10.1055/s-0033-1350840",
language = "English (US)",
volume = "73",
pages = "924--931",
journal = "Geburtshilfe und Frauenheilkunde",
issn = "0016-5751",
publisher = "Georg Thieme Verlag",
number = "9",

}

TY - JOUR

T1 - Adenomyosis

T2 - Epidemiology, risk factors, clinical phenotype and surgical and interventional alternatives to hysterectomy

AU - Taran, F. A.

AU - Stewart, Elizabeth A

AU - Brucker, S.

PY - 2013

Y1 - 2013

N2 - Adenomyosis is an important clinical challenge in gynecology and healthcare economics; in its fully developed form, hysterectomy is often used to treat it in premenopausal and perimenopausal women. Symptoms of adenomyosis typically include menorrhagia, pelvic pain and dysmenorrhea. Moreover, adenomyosis and leiomyomas commonly coexist in the same uterus, and differentiating the symptoms for each pathological process can be problematic. Although it has been recognized for over a century, reliable epidemiological studies on this condition are limited, because only postoperative diagnoses were possible in the past. Minimally invasive surgical techniques (endometrial ablation/resection, myometrial excision/reduction, myometrial electrocoagulation, uterine artery ligation) have had limited success in the treatment of adenomyosis, and the reported data for these procedures have been obtained from case reports or small case series with only short follow-up times. However, newer techniques including uterine artery embolization (UAE) and magnetic resonance imaging guided focused ultrasound (MRgFUS) show promise in treating adenomyosis. The data is strongest for UAE; these studies have the largest patient cohorts. However, none of the UAE studies were randomized or controlled. Thus, despite the clinical importance of adenomyosis, there is little evidence on which to base treatment decisions. The objective of this review is to summarize the epidemiology, risk factors, clinical phenotype and to evaluate the accrued experience with surgical and interventional alternatives to hysterectomy.

AB - Adenomyosis is an important clinical challenge in gynecology and healthcare economics; in its fully developed form, hysterectomy is often used to treat it in premenopausal and perimenopausal women. Symptoms of adenomyosis typically include menorrhagia, pelvic pain and dysmenorrhea. Moreover, adenomyosis and leiomyomas commonly coexist in the same uterus, and differentiating the symptoms for each pathological process can be problematic. Although it has been recognized for over a century, reliable epidemiological studies on this condition are limited, because only postoperative diagnoses were possible in the past. Minimally invasive surgical techniques (endometrial ablation/resection, myometrial excision/reduction, myometrial electrocoagulation, uterine artery ligation) have had limited success in the treatment of adenomyosis, and the reported data for these procedures have been obtained from case reports or small case series with only short follow-up times. However, newer techniques including uterine artery embolization (UAE) and magnetic resonance imaging guided focused ultrasound (MRgFUS) show promise in treating adenomyosis. The data is strongest for UAE; these studies have the largest patient cohorts. However, none of the UAE studies were randomized or controlled. Thus, despite the clinical importance of adenomyosis, there is little evidence on which to base treatment decisions. The objective of this review is to summarize the epidemiology, risk factors, clinical phenotype and to evaluate the accrued experience with surgical and interventional alternatives to hysterectomy.

KW - adenomyosis

KW - endometrial ablation

KW - hysterectomy

KW - magnetic resonance guided focused ultrasound

KW - uterine artery embolization

UR - http://www.scopus.com/inward/record.url?scp=84886907981&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84886907981&partnerID=8YFLogxK

U2 - 10.1055/s-0033-1350840

DO - 10.1055/s-0033-1350840

M3 - Article

VL - 73

SP - 924

EP - 931

JO - Geburtshilfe und Frauenheilkunde

JF - Geburtshilfe und Frauenheilkunde

SN - 0016-5751

IS - 9

ER -