Objective:
To determine the risk factors for adenomyosis and to assess its association with coexisting gynecologic pathologies.
Material and Methods:
The present study was performed retrospectively by analyzing the medical records of 601 patients who underwent hysterectomy for benign indications at a tertiary referral center between 2012 and 2015. According to final pathology reports, 236 patients with adenomyosis and 365 patients without adenomyosis were included in the study. The study groups were compared in terms of surgery indications, demographic and reproductive characteristics, and accompanying pathologies.
Results:
The most common indications for hysterectomy were leiomyoma (56.7%) and uterine prolapse (20.9%). While leiomyoma was the most common pathology that accompanied adenomyosis, endometrial polyps and hyperplasia were also more common in comparison to the patients in control group. The age group in which adenomyosis was most frequently encountered was between 40 and 49 years. History of prior cesarean section, abortion and uterine curettage were found to be risk factors for adenomyosis development.
Conclusions:
Adenomyosis should be included in differential diagnosis, especially in women older than 40 years of age, who present with menometrorrhagia and chronic pelvic pain. Previous cesarean section, abortion and curettage are risk factors for adenomyosis. Since endometrial hyperplasia and polyps commonly accompany this disorder, patients suspected of having adenomyosis should undergo endometrial sampling.
Keywords: adenomyosis, hysterectomy, risk factors, myoma uteri