866:, or surgical removal of the uterus, has historically been the primary method of diagnosing and treating adenomyosis. It was especially popular in women who had completed their childbearing or in cases where fertility was not desired. Today, there are many more medical and surgical interventions available. These treatments, such as hormonal therapy and endometrial ablation, have significantly reduced the number of women who require a hysterectomy. That being said, hysterectomies remain as the final treatment option for women in whom the other treatments have failed. Typically viewed as definitive treatment for the bleeding and pelvic pain associated with adenomyosis, a hysterectomy will always result in sterility and cessation of menstrual bleeding. Pelvic pain, on the other hand, can persist after a hysterectomy in as many as 22% of women.
667:
the menstrual pain. The use of hormonal IUDs in patients with adenomyosis have been proven to reduce menstrual bleeding, improve anemia and iron levels, reduce pain, and even result in an improvement of adenomyosis with a smaller uterus on medical imaging. At least in the short term, patients who can tolerate hormonal IUDs for the treatment of adenomyosis result in equivalent improvement of symptoms and better quality-of-life and social well-being as compared to women who undergo a hysterectomy. Hormonal IUDs are particularly well suited for individuals needing effective treatment of their adenomyosis while still maintaining future fertility potential. The most common negative side-effect of hormonal IUDs is irregular menstrual bleeding or spotting.
777:, or focus on ablating or killing the endometrial layer of the uterus without its immediate removal. Endometrial ablation and resection techniques are most appropriate for shallow adenomyosis. The efficacy of the procedures is reduced if the adenomyosis is too widespread or deep. Furthermore, deep adenomyosis may become trapped behind a scarred region that was ablated, leading to further bleeding and pain. Endometrial resection is also limited to relatively shallow adenomyosis as significant bleeding may result from damage to large arteries that are present 5 mm deep within the myometrium.
279:
445:
728:. This is performed in order to dramatically reduce the blood supply to the uterus. By doing so, there is insufficient blood and thus oxygen present for the adenomyosis to develop and spread. 57-75% of women who undergo UAE for adenomyosis typically report long-term improvement in their menstrual pain and bleeding. However, there is a recurrence rate of symptoms in 35% of women following a UAE. Also, UAE has the risk of causing major complications in 5% of women who undergo the procedure. Major complications include
261:
obstetrical disorders also lies here. Parity, age, and previous uterine abrasion increase the risk of adenomyosis. Hormonal factors such as local hyperestrogenism and elevated levels of s-prolactin as well as autoimmune factors have also been identified as possible risk factors. As both the myometrium and stroma in an adenomyosis affected uterus show significant differences from those of a non-affected uterus, a complex origin that includes multifactorial changes on both genetic and biochemical levels is likely.
350:
533:
34:
265:
estrogen in order to heal the damage. At the same time, estrogen treatment will increase uterine peristalsis again, leading to a vicious circle and a chain of biological alterations essential for the development of adenomyosis. Iatrogenic injury of the junctional zone or physical damage due to placental implantation most likely results in the same pathological cascade.
120:; it differs in that patients with endometriosis present endometrial-like tissue located entirely outside the uterus. In endometriosis, the tissue is similar to, but not the same as, the endometrium. The two conditions are found together in many cases yet often occur separately. Before being recognized as a distinct condition, adenomyosis was called
694:
cardiovascular events, and therefore not feasible for young women. Furthermore, all present treatment options are irrelevant options for women trying to conceive. Exogenous progestogenic treatments have been found to be ineffective. In IVF-settings long down-regulation prior to IVF might have a positive effect on pregnancy rates.
525:. This is because uterine fibroids typically have blood vessels circling the fibroid's capsule. In contrast, adenomyomas are characterized by widespread blood vessels within the lesion. Doppler ultrasonography also serves to differentiate the static fluid within myometrial cysts from flowing blood within vessels.
693:
have been tried in order to relieve adenomyosis related symptoms and show some effect, but the studies are few, mainly with a retrospective study design and have small sample sizes. Long-time use of GnRH-analogues is often associated with heavy side effects, loss of bone density and increased risk of
666:
of the endometrium, reducing or eliminating menstrual flow. Additionally, by helping downregulate estrogen receptors, hormonal IUDs shrink the clusters of endometrial tissue within the myometrium. This leads to reduced menstrual blood flow, helps the uterus contract more properly, and helps to reduce
528:
The junction zone (JZ), or a small distinct hormone-dependent region at the endometrial-myometrial interface, may be assessed by three-dimensional transvaginal ultrasound (3D TVUS) and MRI. Features of adenomyosis are disruption, thickening, enlargement or invasion of the junctional zone. There is no
904:
Variants also exist which combine several of these techniques and surgeries can even change during the operation from one technique to another in response to unforeseen obstacles or individual anatomy considerations. For example, adenomyosis can increase the size of the uterus to such an extent that
553:
Magnetic resonance imaging (MRI) provides slightly better diagnostic capability compared to TVUS, due to the increased ability of MRI to differentiate objectively between different types of soft tissue. This is possible with MRI's higher spatial and contrast resolution. Overall, it is estimated that
744:
can tear through the muscle with minimal force. When successful, the procedure significantly improves menstrual pain and bleeding. Additionally, it can result in improved fertility with pregnancy rates as high as 78% in women trying to conceive after the operation with successful delivery occurring
703:
Broadly speaking, surgical management of adenomyosis is split into two categories: uterine-sparing and non-uterine-sparing procedures. Uterine-sparing procedures are surgical operations that do not include surgical removal of the uterus. Some uterine-sparing procedures have the benefit of improving
264:
The tissue injury and repair (TIAR) theory is now widely accepted and suggests that uterine hyperperistalsis (i.e., increased peristalsis), during early periods of reproductive life will induce micro-injury at the endometrial-myometrial interface (EMI) region. That again leads to elevation of local
739:
Myometrium or adenomyoma resection: In this procedure, surgeons remove a focal consolidation of adenomyosis known as an adenomyoma. To be successful this procedure requires that the adenomyosis is relatively focally isolated and with a minimal diffuse spread. Unfortunately, adenomyosis is commonly
136:
Adenomyosis can vary widely in the type and severity of symptoms that it causes, ranging from being entirely asymptomatic 33% of the time to being a severe and debilitating condition in some cases. Women with adenomyosis typically first report symptoms when they are between 40 and 50, but symptoms
345:
The diagnosis is established when the pathologist finds invading clusters of endometrial tissue within the myometrium. Several diagnostic criterion can be used, but typically they require either the endometrial tissue to have invaded greater than 2% of the myometrium, or a minimum invasion depth
260:
The pathogenesis of adenomyosis still remains unclear, but the functioning of the inner myometrium, also called the junction zone (JZ), is believed to play a major role in the development of adenomyosis. It is also a matter of discussion whether the link between reproductive disorders and major
306:; some treatments try to reduce its levels in order to decrease symptoms. Adenomyosis patients present with heavy menstrual bleeding due to the increase of endometrial tissue, greater degree of vascularization, atypical uterine contractions and increased levels of prostaglandins, estrogen and
467:
Transvaginal ultrasonography is a cheap and readily available imaging test that is typically used early during the evaluation of gynecologic symptoms. Ultrasound imaging, like MRI, does not use radiation and is safe for examination of the pelvis and female reproductive organs. Overall, it is
801:
or complete cessation of menstrual bleeding for 12 months in 23% of patients. 16% of patients eventually experience treatment failure with pain or bleeding requiring additional treatments or a hysterectomy. Women older than 45 and those with milder adenomyosis were more likely to experience
708:. The impact of each procedure on a woman's fertility is of particular concern and typically guides the selection. Non-uterine-sparing procedures, by definition, include surgical removal of the uterus and consequently they will all result in complete sterility.
1263:
Lazzeri L, Di
Giovanni A, Exacoustos C, Tosti C, Pinzauti S, Malzoni M, Petraglia F, Zupi E (August 2014). "Preoperative and Postoperative Clinical and Transvaginal Ultrasound Findings of Adenomyosis in Patients With Deep Infiltrating Endometriosis".
740:
diffuse and the operation is successful only 50% of the time. The procedure is performed with either a laparoscope or hysteroscope. Additionally, it can be a difficult surgery to perform as diffuse adenomyosis physically weakens the myometrium and
673: reduce the menstrual pain and bleeding associated with adenomyosis. This may require taking continuous hormone therapy to reducing or eliminating menstrual flow. Oral contraceptives may even lead to short-term regression of adenomyosis.
588:
Interspersed within the thickened, darker signal of the junctional zone, one will often see foci of hyperintensity (bright spots) on the T2 weighted scans representing small cystically dilatated glands or more acute sites of microhemorrhage.
436:(MRI) can both be used to strongly suggest the diagnosis of adenomyosis, guide treatment options, and monitor response to treatment. Indeed, TVUS and MRI are the only two practical means available to establish a pre-surgical diagnosis.
683:: Progesterone counteracts estrogen and inhibits the growth of endometrial tissue. Such therapy can reduce or eliminate menstruation in a controlled and reversible fashion. Progestins are chemical variants of natural progesterone.
608:
when these hormones decrease. For women in their reproductive years, adenomyosis can typically be managed with the goals to provide pain relief, to restrict progression of the process, and to reduce significant menstrual bleeding.
921:
Adenomyosis is an often progressing condition. It is advocated that adenomyosis poses no increased risk for cancer development. However, both entities could coexist and the endometrial tissue within the myometrium could harbor
108:
endometrium penetrates into hyperplastic myometrial fibers. Unlike the functional layer, the basal layer does not undergo typical cyclic changes with the menstrual cycle. Adenomyosis may involve the uterus focally, creating an
839:
Rollerball ablation: Under direct visualization through a hysteroscope, a metallic ball on the end of a probe is charged with electricity and rolled across the surface of the endometrium. This has been shown to have a
1741:
Nepomnyashchikh LM, Lushnikova EL, Molodykh OP, Pichigina AK (August 2013). "Immunocytochemical analysis of proliferative activity of endometrial and myometrial cell populations in focal and stromal adenomyosis".
562:
of 91% for the detection of adenomyosis. Diagnosis through MRI focuses predominately upon investigating the junctional zone. The uterus will have a thickened junctional zone with darker/diminished signal on both
2720:
2705:
479:
Common transvaginal ultrasound findings are defined by the
European MUSA group in 2015 and are defined in 2022 by the MUSA group. The ultrasound characteristics can be divided in direct and indirect features.
2085:
Van den Bosch T, Dueholm M, Leone FP, Valentin L, Rasmussen CK, Votino A, Van
Schoubroeck D, Landolfo C, Installé AJ, Guerriero S, Exacoustos C, Gordts S, Benacerraf B, D'Hooghe T, De Moor B (September 2015).
240:
The cause of adenomyosis is unknown, although it has been associated with any sort of uterine trauma that may break the barrier between the endometrium and myometrium, known as the junctional zone, such as a
282:
Cross section through the wall of a hysterectomy specimen of a 30-year-old woman who reported chronic pelvic pain and abnormal uterine bleeding. The endometrial surface is at the top of the image, and the
78:), as a result, thickening of the uterus occurs. As well as being misplaced in patients with this condition, endometrial tissue is completely functional. The tissue thickens, sheds and bleeds during every
2151:
Harmsen MJ, Van den Bosch T, de Leeuw RA, Dueholm M, Exacoustos C, Valentin L, Hehenkamp WJ, Groenman F, De Bruyn C, Rasmussen C, Lazzeri L, Jokubkiene L, Jurkovic D, Naftalin J, Tellum T (July 2022).
1306:
833:
Wire-loop resection: Under direct visualization through a hysteroscope, a wire loop instrument charged with an electric current permits a provider to carefully remove the endometrium in strips.
592:
MRI is limited by other factors, but not by calcified uterine fibroids (as is ultrasound). In particular, MRI is better able to differentiate adenomyosis from multiple small uterine fibroids.
844:
effect to the depth of 2–3 mm into the myometrium. This destroys the endometrium and the nearby growth of dysfunctional smooth muscle. Deeper adenomyosis escapes this coagulative effect.
2374:
Bragheto A.M., et al. (2007). "Effectiveness of the levonorgestrel-releasing intrauterine system in the treatment of adenomyosis diagnosed and monitored by magnetic resonance imaging".
2088:"Terms, definitions and measurements to describe sonographic features of myometrium and uterine masses: a consensus opinion from the Morphological Uterus Sonographic Assessment (MUSA) group"
2831:
773:
techniques are only for people who do not want to bear any children after having the surgery. The techniques either include physical resection and removal of the endometrium through a
736:, and needing an additional surgery. UAE has also been shown in some cases to reduce ovarian function. Finally, 26% of women who undergo UAE ultimately end up requiring a hysterectomy.
529:
consensus about the actual histology of the junctional zone and a recent review showed that the ultrasound, MRI and histology all define and describe the junctional zone differently.
797:
Thermal balloon: Using a thin expanding balloon placed within the uterus, providers can introduce heated fluid and ablate the endometrium. This procedure has been shown to result in
1886:
Koike H, Egawa H, Ohtsuka T, Yamaguchi M, Ikenoue T, Mori N (June 1992). "Correlation between dysmenorrheic severity and prostaglandin production in women with endometriosis".
2450:
Niu Z, Chen Q, Sun Y, Feng Y (December 2013). "Long-term pituitary downregulation before frozen embryo transfer could improve pregnancy outcomes in women with adenomyosis".
2539:
Ismiil N, Rasty G, Ghorab Z, et al. (August 2007). "Adenomyosis involved by endometrial adenocarcinoma is a significant risk factor for deep myometrial invasion".
749:
rate (as high as 39% of pregnancies), which is higher than the general population. This is likely due to increased uterine scar tissue formation caused by the surgery.
2824:
85:
The condition is typically found in women between the ages of 35 and 50, but also affects younger women. Patients with adenomyosis often present with painful
704:
fertility or retaining the ability to carry a pregnancy to term. In contrast, some uterine-sparing procedures worsen fertility or even result in complete
2817:
2153:"Consensus on revised definitions of Morphological Uterus Sonographic Assessment (MUSA) features of adenomyosis: results of modified Delphi procedure"
1977:
1839:"Adenomyosis and endometriosis. Re-visiting their association and further insights into the mechanisms of auto-traumatisation. An MRI study"
2314:
Harmsen MJ, Trommelen LM, de Leeuw RA, Tellum T, Juffermans LJ, Griffioen AW, Thomassin-Naggara I, Van den Bosch T, Huirne Ja (July 2023).
322:
microscopically examining small tissue samples of the uterus. These tissue samples can come from a uterine biopsy or directly following a
302:
is the main characteristic for this disease which are the result for high prostaglandin levels. Endometrial proliferation is also led by
816:
whereby using a small probe, providers can directly apply sub-zero temperatures within the uterus to freeze and ablate the endometrium.
493:
Echogenenic subendometrial lines and buds - usually white lines and knobs attached to the endometrium, prtruding into the myometrium.
802:
successful amenorrhea following the procedure. In contrast, women younger than 45, with multiple childbirths, a history of a prior
420:
Adenomyosis can vary widely in the extent and location of its invasion within the uterus. As a result, there are no established
2626:
Stratopoulou CA, Donnez J, Dolmans MM (2021). "Origin and
Pathogenic Mechanisms of Uterine Adenomyosis: What Is Known So Far".
1621:
Kitawaki J, Obayashi H, Ishihara H, Koshiba H, Kusuki I, Kado N, Tsukamoto K, Hasegawa G, Nakamura N, Honjo H (January 2001).
1943:
1311:
544:
with adenomyosis in the posterior wall. Gross enlargement of the posterior wall is noted, with many foci of hyperintensity.
836:
Laser ablation: Under direct visualization through a hysteroscope, lasers are used to vaporize and ablate the endometrium.
3618:
2735:
1547:"The enigmatic uterine junctional zone: the missing link between reproductive disorders and major obstetrical disorders?"
2267:"Role of 3D Ultrasound and Doppler in Differentiating Clinically Suspected Cases of Leiomyoma and Adenomyosis of Uterus"
3262:
1085:
Brosens I, Gordts S, Habiba M, Benagiano G (December 2015). "Uterine Cystic
Adenomyosis: A Disease of Younger Women".
41:
Adenomyosis uteri seen during laparoscopy: soft and enlarged uterus; the blue spots represent subserous endometriosis.
3432:
2951:
758:
819:
Circulating Hot Water: Heated water directly introduced into the uterus is used to thermally ablate the endometrium.
670:
3643:
3137:
3046:
1228:
Struble J, Reid S, Bedaiwy MA (2016). "Adenomyosis: A Clinical Review of a
Challenging Gynecologic Condition".
948:(IVF), women with adenomyosis were less likely to become pregnant and subsequently more likely to experience a
938:
518:
257:, but studies looking into similarities and differences between these two conditions have conflicting results.
205:
154:
147:(40–60%), which is more common in women with deeper adenomyosis. Blood loss may be significant enough to cause
2411:"Adenomyosis and subfertility: a systematic review of prevalence, diagnosis, treatment and fertility outcomes"
1422:"Adenomyosis and subfertility: A systematic review of prevalence, diagnosis, treatment and fertility outcomes"
1362:
Juang CM, Chou P, Yen MS, Twu NF, Horng HC, Hsu WL (2007-02-01). "Adenomyosis and risk of preterm delivery".
825:: Using a small probe introduced into the uterus, a provider uses microwave energy to ablate the endometrium.
721:
1010:
291:
Misplaced endometrial tissue proliferation in the myometrium causes symptoms through different mechanisms.
1837:
Leyendecker G, Bilgicyildirim A, Inacker M, Stalf T, Huppert P, Mall G, Böttcher B, Wildt L (April 2015).
1623:"Oestrogen receptor-alpha gene polymorphism is associated with endometriosis, adenomyosis and leiomyomata"
629:, are commonly used in conjunction with other therapies for pain relief. NSAIDs inhibit the production of
70:
is a medical condition characterized by the growth of cells that proliferate on the inside of the uterus (
3559:
3088:
923:
717:
559:
555:
473:
469:
3554:
3287:
2984:
537:
433:
3603:
3172:
3120:
2939:
2746:
2316:"Uterine junctional zone and adenomyosis: comparison of MRI, transvaginal ultrasound and histology"
2030:"Safety of ultrasonography in pregnancy: WHO systematic review of the literature and meta-analysis"
881:. Also, the varying types of hysterectomy can be performed by many different surgical techniques.
662:, such as the Mirena, are an effective treatment for adenomyosis. They reduce symptoms by causing
200:
or sub-fertility (11–12%) – In addition, adenomyosis is associated with an increased incidence of
3487:
3437:
3393:
3051:
787:
448:
429:
1586:
Kitawaki J (August 2006). "Adenomyosis: the pathophysiology of an oestrogen-dependent disease".
905:
it physically cannot be removed through the vagina without first being cut into smaller pieces.
521:
function can be used during transvaginal ultrasonography to help differentiate adenomyomas from
513:
Irregular or interrupted junctional zone - the borderline between the endometrium and myometrium
3465:
3041:
2880:
2840:
2579:"Uterine adenomyosis and in vitro fertilization outcome: a systematic review and meta-analysis"
2210:"A systematic review with meta-analysis: the common sonographic characteristics of adenomyosis"
1706:
Bergeron C, Amant F, Ferenczy A (August 2006). "Pathology and physiopathology of adenomyosis".
945:
891:
705:
2786:
2492:
2028:
Torloni MR, Vedmedovska N, Merialdi M, Betrán AP, Allen T, González R, Platt LD (2009-05-01).
952:. Given this, it is encouraged to screen women for adenomyosis by TVUS or MRI before starting
3470:
3324:
3267:
3192:
3130:
2991:
2809:
953:
869:
There are many different types of hysterectomy, with varying options existing to removal the
830:
Hysteroscopic procedures: These techniques all require the use of a hysteroscope to perform.
246:
578:
A thickness of the junctional zone greater than 8–12 mm. Less than 8 mm is normal.
3482:
2907:
841:
770:
659:
655:
1498:"Structural and molecular features of the endomyometrium in endometriosis and adenomyosis"
794:
placed within the uterus, providers use high-energy radio waves to ablate the endometrium.
8:
3593:
3532:
3388:
2724:
1461:
Leyendecker G, Kunz G, Kissler S, Wildt L (August 2006). "Adenomyosis and reproduction".
568:
212:
Women with adenomyosis are also more likely to have other uterine conditions, including:
188:
140:
Symptoms (viz., heavy bleeding and pain) and the estimated percent affected may include:
2577:
Vercellini P, Consonni D, Dridi D, Bracco B, Frattaruolo MP, Somigliana E (2014-05-01).
2387:
604:. As adenomyosis is responsive to reproductive hormones, it reasonably abates following
3460:
3417:
3383:
3319:
3282:
3187:
3078:
2979:
2934:
2890:
2885:
2521:
2475:
2353:
2291:
2266:
2242:
2209:
2185:
2152:
2133:
2067:
1863:
1838:
1811:
1786:
1767:
1395:
1289:
822:
2729:
2552:
1337:
806:, and/or a history of menstrual pain were more likely to experience treatment failure.
3475:
3373:
3056:
2944:
2757:
2643:
2608:
2600:
2556:
2513:
2467:
2432:
2391:
2357:
2345:
2337:
2296:
2282:
2247:
2229:
2190:
2172:
2125:
2117:
2059:
2051:
2010:
1939:
1911:
1903:
1899:
1868:
1816:
1759:
1723:
1685:
1644:
1603:
1568:
1527:
1519:
1478:
1443:
1387:
1379:
1375:
1341:
1281:
1245:
1163:
1102:
1064:
1038:
574:
Three objective measures of the junctional zone can be used to diagnose adenomyosis.
278:
242:
228:
46:
2797:
2578:
2479:
1399:
1293:
724:, doctors intentionally block two large arteries that supply the uterus, called the
406:
Low-grade endometrial stromal sarcoma (vs. gland-poor and intravascular adenomyosis)
3598:
3527:
3329:
3157:
2924:
2863:
2635:
2590:
2548:
2505:
2459:
2422:
2383:
2327:
2286:
2278:
2237:
2221:
2180:
2164:
2107:
2099:
2071:
2041:
2000:
1992:
1895:
1858:
1850:
1806:
1798:
1751:
1715:
1675:
1634:
1595:
1558:
1509:
1470:
1433:
1371:
1333:
1273:
1237:
1153:
1094:
444:
2525:
2137:
1996:
1771:
1719:
1599:
1474:
3405:
3348:
3257:
3221:
3162:
3103:
2961:
2872:
2751:
2463:
1936:
Gynecologic pathology: a volume in the series
Foundations in diagnostic pathology
745:
in as many as 69% of those pregnancies. On the other hand, there is an increased
741:
663:
564:
522:
510:
Translational vascularity - diffuse spread of small vessels within the myometrium
425:
216:
79:
1787:"The pathophysiology of endometriosis and adenomyosis: tissue injury and repair"
1545:
Brosens I, Derwig I, Brosens J, Fusi L, Benagiano G, Pijnenborg R (March 2010).
1158:
1141:
490:
Hyperechogenic islands - usually white endometrium islands within the myometrium
128:
is a more specific name for the condition, specifying involvement of the uterus.
3580:
3442:
3334:
3294:
3272:
3108:
2971:
2956:
2900:
2639:
1241:
1098:
934:
803:
725:
634:
353:
201:
2714:
2509:
1854:
1802:
1755:
581:
A junctional zone width being greater than 40% of the width of the myometrium.
3637:
3588:
3113:
3098:
3061:
2996:
2914:
2762:
2647:
2604:
2341:
2233:
2225:
2176:
2121:
2055:
1907:
1680:
1663:
1639:
1622:
1523:
1383:
1277:
870:
791:
784:, are relatively fast, and many can be performed as an outpatient procedure.
630:
584:
Variability in the width of the junctional zone being greater than 5 mm.
421:
403:
Myo-invasive endometrial endometrioid carcinoma (vs. stroma-poor adenomyosis)
295:
254:
222:
117:
2595:
2427:
2410:
2087:
1563:
1546:
1514:
1497:
1438:
1421:
3507:
3360:
3239:
3147:
3125:
3066:
3001:
2929:
2844:
2612:
2560:
2517:
2471:
2436:
2395:
2349:
2300:
2251:
2194:
2129:
2063:
2014:
1872:
1820:
1763:
1727:
1648:
1607:
1572:
1531:
1482:
1447:
1391:
1345:
1285:
1249:
1167:
1139:
1106:
1068:
1042:
878:
863:
858:
809:
781:
774:
686:
676:
638:
601:
386:
Endometrial glands and stroma haphazardly distributed throughout myometrium
361:
357:
331:
323:
299:
162:
90:
1915:
1740:
1689:
504:
Fan shaped shadowing - differentiating from fibroids with linear shadowing
487:
myometrial cysts - pockets of fluid within the smooth muscle of the uterus
349:
3512:
3427:
3400:
3364:
3310:
3231:
3142:
3029:
3006:
2895:
2781:
2661:
949:
874:
813:
798:
746:
456:
452:
327:
319:
197:
168:
144:
98:
94:
71:
2697:
3613:
3497:
3447:
3369:
3277:
3208:
3093:
2919:
2112:
2005:
1005:
680:
307:
110:
75:
51:
2332:
2315:
2168:
2103:
1929:
1927:
1925:
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2848:
2792:
2046:
2029:
1836:
729:
622:
605:
250:
2408:
1419:
424:
features to allow for a definitive diagnosis of adenomyosis through
3608:
3314:
2150:
1922:
733:
626:
303:
2496:
Levgur M (2007). "Therapeutic options for adenomyosis: a review".
1985:
Best
Practice & Research Clinical Obstetrics & Gynaecology
532:
389:
Concentric myometrial hyperplasia frequent around adenomyotic foci
113:. With diffuse involvement, the uterus becomes bulky and heavier.
2084:
1262:
1142:"Endometriosis results from the dislocation of basal endometrium"
690:
637:. Prostaglandins have been shown to be primarily responsible for
2740:
2409:
Maheshwari A, Gurunath S, Fatima F, Bhattacharya S (July 2012).
2027:
780:
Non-hysteroscopic procedures: These techniques do not require a
151:, with associated symptoms of fatigue, dizziness, and moodiness.
3249:
3020:
2709:
1701:
1699:
1620:
984:
642:
541:
339:
335:
284:
148:
86:
2839:
2313:
1364:
33:
2576:
1978:"Imaging for the evaluation of endometriosis and adenomyosis"
1324:
Matalliotakis I, Kourtis A, Panidis D (2003). "Adenomyosis".
974:
618:
191:(30%), which in turn can lead to symptoms of pelvic fullness.
101:, chronic pelvic pain and irritation of the urinary bladder.
1696:
1084:
1460:
1420:
Maheshwari A, Gurunath S, Fatima F, Bhattacharya S (2012).
1323:
897:
entirely by route of the vagina with no abdominal incisions
1885:
1140:
Leyendecker, G., Herbertz, M., Kunz, G., Mall, G. (2002).
74:) atypically located among the cells of the uterine wall (
2625:
1661:
1544:
428:. Nevertheless, non-invasive imaging techniques such as
1975:
1888:
Prostaglandins, Leukotrienes and
Essential Fatty Acids
1495:
941:
both occur more frequently in women with adenomyosis.
1705:
764:
378:
Hemorrhagic pinpoint or cystic spaces throughout wall
2687:
1784:
1489:
888:
laparoscopically through small holes in the abdomen
375:
Thickened uterine wall with trabeculated appearance
16:
Extension of endometrial tissue into the myometrium
1326:Obstetrics and Gynecology Clinics of North America
1227:
649:
468:estimated that transvaginal ultrasonography has a
298:, which is produced by normal endometrial tissue.
2538:
1415:
1413:
1411:
1409:
894:in a manner similar to the laparoscopic procedure
852:
621:: Nonsterioidal anti-inflammatory drugs, such as
3635:
1662:Ota H, Igarashi S, Hatazawa J, Tanaka T (1998).
1129:(5th ed.). Philadelphia PA: Mosby Elsevier.
600:Adenomyosis can only be cured definitively with
392:Variants: Gland-poor, stroma-poor, intravascular
1832:
1830:
1785:Leyendecker G, Wildt L, Mall G (October 2009).
1361:
913:Recent data suggest a prevalence of 20 to 35%.
439:
326:. Uterine biopsies can be obtained by either a
2449:
1406:
1120:
1118:
1116:
687:Gonadotropin-releasing hormone (GnRH) agonists
633:by decreasing the activity of the enzyme
2825:
2373:
1032:
926:, with potentially deep myometrial invasion.
711:
656:Levonorgestrel-releasing intrauterine devices
548:
294:Uterine menstrual contractions are caused by
2443:
2402:
1827:
1778:
1734:
1614:
1579:
1538:
1454:
1033:Gunther R, Walker CW (2020). "Adenomyosis".
641:or the cramping pelvic pain associated with
501:Globular, enlarged, and/or asymmetric uterus
184:Clinical signs of adenomyosis may include:
2271:Journal of Clinical and Diagnostic Research
1655:
1256:
1113:
2832:
2818:
1976:Exacoustos C, Manganaro L, Zupi E (2014).
1938:(Second ed.). Elsevier. p. 489.
318:The diagnosis of adenomyosis is through a
32:
2594:
2426:
2331:
2320:Ultrasound in Obstetrics & Gynecology
2290:
2241:
2207:
2184:
2157:Ultrasound in Obstetrics & Gynecology
2111:
2092:Ultrasound in Obstetrics & Gynecology
2045:
2004:
1862:
1810:
1679:
1638:
1562:
1513:
1496:Benagiano G, Brosens I, Habiba M (2013).
1437:
1157:
476:of 85% for the detection of adenomyosis.
356:image of uterine adenomyosis observed in
1585:
1230:Journal of Minimally Invasive Gynecology
531:
443:
348:
277:
97:), or both. Other possible symptoms are
2034:Ultrasound in Obstetrics and Gynecology
1124:
1028:
1026:
180:Dragging sensation down thighs and legs
116:Adenomyosis can be found together with
3636:
2495:
2264:
954:assisted reproduction treatments (ART)
2862:
2813:
2572:
2570:
2498:Archives of Gynecology and Obstetrics
2369:
2367:
1971:
1969:
1967:
1965:
1963:
1961:
1959:
1957:
1955:
1933:
1357:
1355:
1223:
1221:
1219:
1217:
1215:
1213:
1211:
1209:
1207:
1205:
1203:
1201:
1199:
1197:
759:MRI-guided focused ultrasound surgery
131:
2654:
2619:
2486:
1195:
1193:
1191:
1189:
1187:
1185:
1183:
1181:
1179:
1177:
1080:
1078:
1054:
1052:
1023:
459:(brighter) area in the middle, with
3619:Persistent genital arousal disorder
2388:10.1016/j.contraception.2007.05.091
1708:Best Pract Res Clin Obstet Gynaecol
1664:"Is adenomyosis an immune disease?"
1588:Best Pract Res Clin Obstet Gynaecol
1463:Best Pract Res Clin Obstet Gynaecol
900:through a larger abdominal incision
788:High-energy radiofrequency ablation
13:
2567:
2364:
1952:
1352:
1058:
944:In sub-fertile women who received
884:A hysterectomy can be performed:
765:Endometrial ablation and resection
273:
14:
3655:
3433:Hypoactive sexual desire disorder
2952:Ovarian hyperstimulation syndrome
2683:
2553:10.1016/j.anndiagpath.2006.08.011
1174:
1075:
1049:
507:Anterior/posterior wall asymmetry
330:procedure through the abdomen or
313:
2662:"-OSIS Definition & Meaning"
1376:10.1111/j.1471-0528.2006.01186.x
1059:R G, C W (2020). "Adenomyosis".
968:is derived from the Greek terms
2532:
2307:
2258:
2201:
2144:
2078:
2021:
1879:
908:
650:Hormones and hormone modulators
3047:Dysfunctional uterine bleeding
1317:
1300:
1133:
939:premature rupture of membranes
853:Non-uterine-sparing procedures
612:
602:surgical removal of the uterus
540:of a woman's pelvis showing a
206:premature rupture of membranes
124:. The less-commonly-used term
99:pain during sexual intercourse
1:
1997:10.1016/j.bpobgyn.2014.04.010
1720:10.1016/j.bpobgyn.2006.01.016
1600:10.1016/j.bpobgyn.2006.01.010
1475:10.1016/j.bpobgyn.2006.01.008
1338:10.1016/S0889-8545(02)00053-0
1016:
752:Myometrial electrocoagulation
362:Hematoxylin & eosin stain
163:Painful cramping menstruation
3143:Menorrhagia (hypermenorrhea)
3114:Polymenorrhea (epimenorrhea)
2464:10.3109/09513590.2013.824960
2283:10.7860/jcdr/2015/12240.5846
1934:Nucci MR (3 February 2020).
1900:10.1016/0952-3278(92)90219-9
1312:Dorland's Medical Dictionary
1011:Atypical polypoid adenomyoma
959:
929:
916:
722:minimally-invasive procedure
595:
440:Transvaginal ultrasonography
430:transvaginal ultrasonography
410:
268:
137:can occur in younger women.
7:
3560:Pelvic inflammatory disease
999:
924:endometrioid adenocarcinoma
718:Uterine artery embolization
451:of the uterus, showing the
169:Painful vaginal intercourse
10:
3660:
3555:Pelvic congestion syndrome
2985:Fallopian tube obstruction
2640:10.1007/s43032-020-00361-w
2208:Dartmouth K (2014-08-01).
1242:10.1016/j.jmig.2015.09.018
1099:10.1016/j.jpag.2014.05.008
856:
712:Uterine-sparing procedures
698:
549:Magnetic resonance imaging
434:magnetic resonance imaging
415:
3604:Vestibular papillomatosis
3579:
3572:
3547:
3523:
3456:
3414:
3356:
3347:
3303:
3248:
3230:
3207:
3183:
3173:Metropathia haemorrhagica
3075:
3037:
3028:
3019:
2970:
2871:
2855:
2772:
2691:
2510:10.1007/S00404-006-0299-8
1855:10.1007/s00404-014-3437-8
1803:10.1007/s00404-009-1191-0
1756:10.1007/s10517-013-2190-5
1502:Human Reproduction Update
1426:Human Reproduction Update
1159:10.1093/humrep/17.10.2725
1087:J Pediatr Adolesc Gynecol
810:Cryo-endometrial ablation
463:extending upwards from it
235:
159:Chronic pelvic pain (77%)
155:Abnormal uterine bleeding
57:
45:
40:
31:
26:
2940:Follicular cyst of ovary
2226:10.1177/1742271X14528837
1278:10.1177/1933719114522520
1127:Comprehensive gynecology
396:Differential Diagnosis:
253:. It can be linked with
174:A 'bearing' down feeling
145:Heavy menstrual bleeding
3438:Sexual arousal disorder
3394:Candidal vulvovaginitis
3052:Endometrial hyperplasia
519:Doppler ultrasonography
449:Transvaginal ultrasound
3644:Gynaecologic disorders
2881:Endometriosis of ovary
1681:10.1093/humupd/4.4.360
1640:10.1093/humrep/16.1.51
946:in-vitro fertilization
545:
464:
382:Microscopic Findings:
365:
288:
3325:Vesicouterine fistula
3268:Cervical incompetence
3193:Recurrent miscarriage
3131:Premenstrual syndrome
2992:Fallopian tube cancer
2628:Reproductive Sciences
2596:10.1093/humrep/deu041
2428:10.1093/humupd/dms006
1843:Arch. Gynecol. Obstet
1791:Arch. Gynecol. Obstet
1564:10.1093/humrep/dep474
1515:10.1093/humupd/dmt052
1439:10.1093/humupd/dms006
535:
517:The power Doppler or
447:
352:
281:
247:pregnancy termination
122:endometriosis interna
3483:Rectovaginal fistula
2908:Poor ovarian reserve
1744:Bull. Exp. Biol. Med
771:Endometrial ablation
755:Myometrial reduction
734:significant bleeding
426:non-invasive imaging
346:between 2.5 and 8mm.
3533:Postcoital bleeding
3461:Urogenital fistulas
3389:Bacterial vaginosis
3042:Asherman's syndrome
2452:Gynecol. Endocrinol
2415:Hum. Reprod. Update
1668:Hum. Reprod. Update
671:Oral contraceptives
497:Indirect features:
189:Uterine enlargement
177:Pressure on bladder
93:), profuse menses (
3418:Sexual dysfunction
3384:Atrophic vaginitis
3320:Retroverted uterus
3283:Female infertility
3263:Cervical dysplasia
3188:Female infertility
2980:Female infertility
2935:Corpus luteum cyst
2891:Ovulatory disorder
2886:Female infertility
2773:External resources
2583:Human Reproduction
1332:(1): 63–82, viii.
1307:"adenomyometritis"
823:Microwave ablation
546:
465:
366:
289:
132:Signs and symptoms
3631:
3630:
3627:
3626:
3568:
3567:
3543:
3542:
3476:Obstetric fistula
3374:Vaginal discharge
3343:
3342:
3288:Cervical stenosis
3203:
3202:
3057:Endometrial polyp
3015:
3014:
2945:Theca lutein cyst
2807:
2806:
2333:10.1002/uog.26117
2265:Sharma K (2015).
2169:10.1002/uog.24786
2104:10.1002/uog.14806
1945:978-0-323-35909-2
1152:(10): 2725–2736.
812:(CEA): A form of
483:Direct features:
461:linear striations
354:Histopathological
287:is at the bottom.
243:caesarean section
229:Endometrial polyp
65:
64:
21:Medical condition
3651:
3599:Kraurosis vulvae
3594:Bartholin's cyst
3577:
3576:
3528:Vaginal bleeding
3421:
3354:
3353:
3330:Uterine prolapse
3158:Menometrorrhagia
3082:
3035:
3034:
3026:
3025:
2925:Ovarian apoplexy
2869:
2868:
2860:
2859:
2834:
2827:
2820:
2811:
2810:
2689:
2688:
2677:
2676:
2674:
2673:
2658:
2652:
2651:
2634:(8): 2087–2097.
2623:
2617:
2616:
2598:
2574:
2565:
2564:
2541:Ann Diagn Pathol
2536:
2530:
2529:
2490:
2484:
2483:
2447:
2441:
2440:
2430:
2406:
2400:
2399:
2371:
2362:
2361:
2335:
2311:
2305:
2304:
2294:
2262:
2256:
2255:
2245:
2205:
2199:
2198:
2188:
2148:
2142:
2141:
2115:
2082:
2076:
2075:
2049:
2047:10.1002/uog.6328
2025:
2019:
2018:
2008:
1982:
1973:
1950:
1949:
1931:
1920:
1919:
1883:
1877:
1876:
1866:
1834:
1825:
1824:
1814:
1782:
1776:
1775:
1738:
1732:
1731:
1703:
1694:
1693:
1683:
1659:
1653:
1652:
1642:
1618:
1612:
1611:
1583:
1577:
1576:
1566:
1542:
1536:
1535:
1517:
1493:
1487:
1486:
1458:
1452:
1451:
1441:
1417:
1404:
1403:
1359:
1350:
1349:
1321:
1315:
1304:
1298:
1297:
1272:(8): 1027–1033.
1260:
1254:
1253:
1225:
1172:
1171:
1161:
1137:
1131:
1130:
1125:Katz VL (2007).
1122:
1111:
1110:
1082:
1073:
1072:
1056:
1047:
1046:
1030:
790:: Using a small
742:surgical sutures
726:uterine arteries
523:uterine fibroids
368:Gross Findings:
217:Uterine fibroids
126:adenomyometritis
104:In adenomyosis,
36:
24:
23:
3659:
3658:
3654:
3653:
3652:
3650:
3649:
3648:
3634:
3633:
3632:
3623:
3564:
3539:
3519:
3452:
3415:
3410:
3406:Vaginal atresia
3339:
3299:
3258:Cervical cancer
3244:
3226:
3222:Uterine fibroid
3199:
3179:
3163:Polymenorrhagia
3104:Oligoamenorrhea
3076:
3071:
3011:
2966:
2962:Ovarian torsion
2851:
2841:Female diseases
2838:
2808:
2803:
2802:
2768:
2767:
2700:
2686:
2681:
2680:
2671:
2669:
2660:
2659:
2655:
2624:
2620:
2575:
2568:
2537:
2533:
2491:
2487:
2458:(12): 1026–30.
2448:
2444:
2407:
2403:
2372:
2365:
2312:
2308:
2263:
2259:
2206:
2202:
2149:
2145:
2083:
2079:
2026:
2022:
1980:
1974:
1953:
1946:
1932:
1923:
1884:
1880:
1835:
1828:
1783:
1779:
1739:
1735:
1704:
1697:
1660:
1656:
1619:
1615:
1584:
1580:
1543:
1539:
1494:
1490:
1459:
1455:
1418:
1407:
1360:
1353:
1322:
1318:
1305:
1301:
1261:
1257:
1226:
1175:
1138:
1134:
1123:
1114:
1083:
1076:
1057:
1050:
1031:
1024:
1019:
1002:
962:
932:
919:
911:
871:fallopian tubes
861:
855:
792:expandable mesh
767:
720:(UAE): In this
714:
701:
664:decidualization
652:
615:
598:
551:
442:
418:
413:
372:Enlarged uterus
316:
276:
274:Pathophysiology
271:
238:
171:, uncommon (7%)
134:
80:menstrual cycle
22:
17:
12:
11:
5:
3657:
3647:
3646:
3629:
3628:
3625:
3624:
3622:
3621:
3616:
3611:
3606:
3601:
3596:
3591:
3585:
3583:
3574:
3570:
3569:
3566:
3565:
3563:
3562:
3557:
3551:
3549:
3545:
3544:
3541:
3540:
3538:
3537:
3536:
3535:
3524:
3521:
3520:
3518:
3517:
3516:
3515:
3510:
3505:
3500:
3495:
3485:
3480:
3479:
3478:
3473:
3468:
3466:Ureterovaginal
3457:
3454:
3453:
3451:
3450:
3445:
3443:Vaginal cancer
3440:
3435:
3430:
3424:
3422:
3412:
3411:
3409:
3408:
3403:
3398:
3397:
3396:
3391:
3386:
3376:
3367:
3357:
3351:
3345:
3344:
3341:
3340:
3338:
3337:
3335:Uterine cancer
3332:
3327:
3322:
3317:
3307:
3305:
3301:
3300:
3298:
3297:
3295:Nabothian cyst
3292:
3291:
3290:
3280:
3275:
3273:Cervical polyp
3270:
3265:
3260:
3254:
3252:
3246:
3245:
3243:
3242:
3236:
3234:
3228:
3227:
3225:
3224:
3219:
3213:
3211:
3205:
3204:
3201:
3200:
3198:
3197:
3196:
3195:
3184:
3181:
3180:
3178:
3177:
3176:
3175:
3167:
3166:
3165:
3160:
3152:
3151:
3150:
3145:
3135:
3134:
3133:
3128:
3118:
3117:
3116:
3111:
3109:Oligomenorrhea
3106:
3101:
3096:
3085:
3083:
3073:
3072:
3070:
3069:
3064:
3059:
3054:
3049:
3044:
3038:
3032:
3023:
3017:
3016:
3013:
3012:
3010:
3009:
3004:
2999:
2994:
2989:
2988:
2987:
2976:
2974:
2972:Fallopian tube
2968:
2967:
2965:
2964:
2959:
2957:Ovarian cancer
2954:
2949:
2948:
2947:
2942:
2937:
2927:
2922:
2917:
2912:
2911:
2910:
2905:
2904:
2903:
2901:Oligoovulation
2898:
2883:
2877:
2875:
2866:
2857:
2853:
2852:
2837:
2836:
2829:
2822:
2814:
2805:
2804:
2801:
2800:
2789:
2777:
2776:
2774:
2770:
2769:
2766:
2765:
2754:
2743:
2732:
2717:
2701:
2696:
2695:
2693:
2692:Classification
2685:
2684:External links
2682:
2679:
2678:
2666:Dictionary.com
2653:
2618:
2589:(5): 964–977.
2566:
2531:
2485:
2442:
2401:
2363:
2306:
2277:(4): QC08–12.
2257:
2220:(3): 148–157.
2200:
2163:(1): 118–131.
2143:
2098:(3): 284–298.
2077:
2040:(5): 599–608.
2020:
1991:(5): 655–681.
1951:
1944:
1921:
1894:(2): 133–137.
1878:
1826:
1777:
1733:
1695:
1654:
1613:
1594:(4): 493–502.
1578:
1537:
1508:(3): 386–402.
1488:
1453:
1432:(4): 374–392.
1405:
1370:(2): 165–169.
1351:
1316:
1299:
1255:
1236:(2): 164–185.
1173:
1132:
1112:
1074:
1048:
1021:
1020:
1018:
1015:
1014:
1013:
1008:
1001:
998:
961:
958:
935:Preterm labour
931:
928:
918:
915:
910:
907:
902:
901:
898:
895:
889:
854:
851:
850:
849:
848:
847:
846:
845:
837:
834:
828:
827:
826:
820:
817:
807:
804:tubal ligation
795:
766:
763:
762:
761:
756:
753:
750:
737:
713:
710:
700:
697:
696:
695:
684:
679: or
674:
668:
651:
648:
647:
646:
635:cyclooxygenase
631:prostaglandins
614:
611:
597:
594:
586:
585:
582:
579:
550:
547:
515:
514:
511:
508:
505:
502:
495:
494:
491:
488:
441:
438:
417:
414:
412:
409:
408:
407:
404:
401:
394:
393:
390:
387:
380:
379:
376:
373:
315:
314:Histopathology
312:
275:
272:
270:
267:
237:
234:
233:
232:
226:
220:
210:
209:
202:preterm labour
195:
192:
182:
181:
178:
175:
172:
166:
160:
157:
152:
133:
130:
63:
62:
59:
55:
54:
49:
43:
42:
38:
37:
29:
28:
20:
15:
9:
6:
4:
3:
2:
3656:
3645:
3642:
3641:
3639:
3620:
3617:
3615:
3612:
3610:
3607:
3605:
3602:
3600:
3597:
3595:
3592:
3590:
3589:Vulvar cancer
3587:
3586:
3584:
3582:
3578:
3575:
3571:
3561:
3558:
3556:
3553:
3552:
3550:
3546:
3534:
3531:
3530:
3529:
3526:
3525:
3522:
3514:
3511:
3509:
3506:
3504:
3501:
3499:
3496:
3494:
3491:
3490:
3489:
3486:
3484:
3481:
3477:
3474:
3472:
3471:Vesicovaginal
3469:
3467:
3464:
3463:
3462:
3459:
3458:
3455:
3449:
3446:
3444:
3441:
3439:
3436:
3434:
3431:
3429:
3426:
3425:
3423:
3420:
3419:
3413:
3407:
3404:
3402:
3399:
3395:
3392:
3390:
3387:
3385:
3382:
3381:
3380:
3377:
3375:
3371:
3368:
3366:
3362:
3359:
3358:
3355:
3352:
3350:
3346:
3336:
3333:
3331:
3328:
3326:
3323:
3321:
3318:
3316:
3312:
3309:
3308:
3306:
3302:
3296:
3293:
3289:
3286:
3285:
3284:
3281:
3279:
3276:
3274:
3271:
3269:
3266:
3264:
3261:
3259:
3256:
3255:
3253:
3251:
3247:
3241:
3238:
3237:
3235:
3233:
3229:
3223:
3220:
3218:
3215:
3214:
3212:
3210:
3206:
3194:
3191:
3190:
3189:
3186:
3185:
3182:
3174:
3171:
3170:
3168:
3164:
3161:
3159:
3156:
3155:
3153:
3149:
3146:
3144:
3141:
3140:
3139:
3136:
3132:
3129:
3127:
3124:
3123:
3122:
3119:
3115:
3112:
3110:
3107:
3105:
3102:
3100:
3099:Hypomenorrhea
3097:
3095:
3092:
3091:
3090:
3087:
3086:
3084:
3081:
3080:
3074:
3068:
3065:
3063:
3062:Endometriosis
3060:
3058:
3055:
3053:
3050:
3048:
3045:
3043:
3040:
3039:
3036:
3033:
3031:
3027:
3024:
3022:
3018:
3008:
3005:
3003:
3000:
2998:
2997:Hematosalpinx
2995:
2993:
2990:
2986:
2983:
2982:
2981:
2978:
2977:
2975:
2973:
2969:
2963:
2960:
2958:
2955:
2953:
2950:
2946:
2943:
2941:
2938:
2936:
2933:
2932:
2931:
2928:
2926:
2923:
2921:
2918:
2916:
2915:Mittelschmerz
2913:
2909:
2906:
2902:
2899:
2897:
2894:
2893:
2892:
2889:
2888:
2887:
2884:
2882:
2879:
2878:
2876:
2874:
2870:
2867:
2865:
2861:
2858:
2854:
2850:
2846:
2842:
2835:
2830:
2828:
2823:
2821:
2816:
2815:
2812:
2799:
2795:
2794:
2790:
2788:
2784:
2783:
2779:
2778:
2775:
2771:
2764:
2760:
2759:
2755:
2753:
2749:
2748:
2744:
2742:
2738:
2737:
2733:
2731:
2727:
2726:
2722:
2718:
2716:
2712:
2711:
2707:
2703:
2702:
2699:
2694:
2690:
2667:
2663:
2657:
2649:
2645:
2641:
2637:
2633:
2629:
2622:
2614:
2610:
2606:
2602:
2597:
2592:
2588:
2584:
2580:
2573:
2571:
2562:
2558:
2554:
2550:
2546:
2542:
2535:
2527:
2523:
2519:
2515:
2511:
2507:
2503:
2499:
2493:
2489:
2481:
2477:
2473:
2469:
2465:
2461:
2457:
2453:
2446:
2438:
2434:
2429:
2424:
2421:(4): 374–92.
2420:
2416:
2412:
2405:
2397:
2393:
2389:
2385:
2381:
2377:
2376:Contraception
2370:
2368:
2359:
2355:
2351:
2347:
2343:
2339:
2334:
2329:
2325:
2321:
2317:
2310:
2302:
2298:
2293:
2288:
2284:
2280:
2276:
2272:
2268:
2261:
2253:
2249:
2244:
2239:
2235:
2231:
2227:
2223:
2219:
2215:
2211:
2204:
2196:
2192:
2187:
2182:
2178:
2174:
2170:
2166:
2162:
2158:
2154:
2147:
2139:
2135:
2131:
2127:
2123:
2119:
2114:
2109:
2105:
2101:
2097:
2093:
2089:
2081:
2073:
2069:
2065:
2061:
2057:
2053:
2048:
2043:
2039:
2035:
2031:
2024:
2016:
2012:
2007:
2002:
1998:
1994:
1990:
1986:
1979:
1972:
1970:
1968:
1966:
1964:
1962:
1960:
1958:
1956:
1947:
1941:
1937:
1930:
1928:
1926:
1917:
1913:
1909:
1905:
1901:
1897:
1893:
1889:
1882:
1874:
1870:
1865:
1860:
1856:
1852:
1849:(4): 917–32.
1848:
1844:
1840:
1833:
1831:
1822:
1818:
1813:
1808:
1804:
1800:
1797:(4): 529–38.
1796:
1792:
1788:
1781:
1773:
1769:
1765:
1761:
1757:
1753:
1749:
1745:
1737:
1729:
1725:
1721:
1717:
1714:(4): 511–21.
1713:
1709:
1702:
1700:
1691:
1687:
1682:
1677:
1673:
1669:
1665:
1658:
1650:
1646:
1641:
1636:
1632:
1628:
1624:
1617:
1609:
1605:
1601:
1597:
1593:
1589:
1582:
1574:
1570:
1565:
1560:
1557:(3): 569–74.
1556:
1552:
1548:
1541:
1533:
1529:
1525:
1521:
1516:
1511:
1507:
1503:
1499:
1492:
1484:
1480:
1476:
1472:
1469:(4): 523–46.
1468:
1464:
1457:
1449:
1445:
1440:
1435:
1431:
1427:
1423:
1416:
1414:
1412:
1410:
1401:
1397:
1393:
1389:
1385:
1381:
1377:
1373:
1369:
1365:
1358:
1356:
1347:
1343:
1339:
1335:
1331:
1327:
1320:
1314:
1313:
1308:
1303:
1295:
1291:
1287:
1283:
1279:
1275:
1271:
1267:
1259:
1251:
1247:
1243:
1239:
1235:
1231:
1224:
1222:
1220:
1218:
1216:
1214:
1212:
1210:
1208:
1206:
1204:
1202:
1200:
1198:
1196:
1194:
1192:
1190:
1188:
1186:
1184:
1182:
1180:
1178:
1169:
1165:
1160:
1155:
1151:
1147:
1143:
1136:
1128:
1121:
1119:
1117:
1108:
1104:
1100:
1096:
1092:
1088:
1081:
1079:
1070:
1066:
1062:
1055:
1053:
1044:
1040:
1036:
1029:
1027:
1022:
1012:
1009:
1007:
1004:
1003:
997:
995:
991:
987:
986:
981:
977:
976:
971:
967:
957:
955:
951:
947:
942:
940:
936:
927:
925:
914:
906:
899:
896:
893:
890:
887:
886:
885:
882:
880:
876:
872:
867:
865:
860:
843:
838:
835:
832:
831:
829:
824:
821:
818:
815:
811:
808:
805:
800:
796:
793:
789:
786:
785:
783:
779:
778:
776:
772:
769:
768:
760:
757:
754:
751:
748:
743:
738:
735:
731:
727:
723:
719:
716:
715:
709:
707:
692:
688:
685:
682:
678:
675:
672:
669:
665:
661:
660:hormonal IUDs
657:
654:
653:
644:
640:
636:
632:
628:
624:
620:
617:
616:
610:
607:
603:
593:
590:
583:
580:
577:
576:
575:
572:
570:
566:
561:
557:
543:
539:
534:
530:
526:
524:
520:
512:
509:
506:
503:
500:
499:
498:
492:
489:
486:
485:
484:
481:
477:
475:
471:
462:
458:
454:
450:
446:
437:
435:
431:
427:
423:
422:pathognomonic
405:
402:
399:
398:
397:
391:
388:
385:
384:
383:
377:
374:
371:
370:
369:
363:
359:
355:
351:
347:
343:
341:
337:
333:
329:
325:
321:
311:
309:
305:
301:
297:
296:prostaglandin
292:
286:
280:
266:
262:
258:
256:
255:endometriosis
252:
248:
244:
230:
227:
224:
223:Endometriosis
221:
218:
215:
214:
213:
207:
203:
199:
196:
194:Tender uterus
193:
190:
187:
186:
185:
179:
176:
173:
170:
167:
164:
161:
158:
156:
153:
150:
146:
143:
142:
141:
138:
129:
127:
123:
119:
118:endometriosis
114:
112:
107:
102:
100:
96:
92:
88:
83:
81:
77:
73:
69:
60:
56:
53:
50:
48:
44:
39:
35:
30:
25:
19:
3508:Sigmoidocele
3416:
3361:Hematocolpos
3240:Parametritis
3216:
3148:Metrorrhagia
3126:Dysmenorrhea
3079:Menstruation
3077:
3067:Endometritis
3002:Hydrosalpinx
2930:Ovarian cyst
2791:
2780:
2756:
2745:
2734:
2719:
2704:
2670:. Retrieved
2668:. 2023-07-04
2665:
2656:
2631:
2627:
2621:
2586:
2582:
2547:(4): 252–7.
2544:
2540:
2534:
2501:
2497:
2488:
2455:
2451:
2445:
2418:
2414:
2404:
2382:(3): 195–9.
2379:
2375:
2326:(1): 42–60.
2323:
2319:
2309:
2274:
2270:
2260:
2217:
2213:
2203:
2160:
2156:
2146:
2095:
2091:
2080:
2037:
2033:
2023:
1988:
1984:
1935:
1891:
1887:
1881:
1846:
1842:
1794:
1790:
1780:
1750:(4): 512–7.
1747:
1743:
1736:
1711:
1707:
1674:(4): 360–7.
1671:
1667:
1657:
1633:(1): 51–55.
1630:
1626:
1616:
1591:
1587:
1581:
1554:
1550:
1540:
1505:
1501:
1491:
1466:
1462:
1456:
1429:
1425:
1367:
1363:
1329:
1325:
1319:
1310:
1302:
1269:
1265:
1258:
1233:
1229:
1149:
1145:
1135:
1126:
1093:(6): 420–6.
1090:
1086:
1060:
1034:
993:
989:
983:
979:
973:
969:
965:
963:
943:
933:
920:
912:
909:Epidemiology
903:
883:
868:
864:Hysterectomy
862:
859:Hysterectomy
782:hysteroscope
775:hysteroscope
702:
677:Progesterone
639:dysmenorrhea
599:
591:
587:
573:
552:
527:
516:
496:
482:
478:
466:
460:
419:
395:
381:
367:
358:hysterectomy
344:
334:through the
332:hysteroscopy
328:laparoscopic
324:hysterectomy
317:
300:Dysmenorrhea
293:
290:
263:
259:
245:, surgical
239:
211:
183:
139:
135:
125:
121:
115:
105:
103:
91:dysmenorrhea
84:
67:
66:
18:
3513:Urethrocele
3428:Dyspareunia
3401:Hydrocolpos
3365:Hydrocolpos
3311:Hematometra
3232:Parametrium
3217:Adenomyosis
3030:Endometrium
3007:Salpingitis
2896:Anovulation
2782:MedlinePlus
2504:(1): 1–15.
2113:2108/137794
2006:2108/137400
1627:Hum. Reprod
1551:Hum. Reprod
1146:Hum. Reprod
1061:StatPearls
966:adenomyosis
950:miscarriage
892:robotically
842:coagulative
814:cryotherapy
747:miscarriage
613:Medications
571:sequences.
569:T2 weighted
560:specificity
558:of 74% and
556:sensitivity
474:specificity
472:of 79% and
470:sensitivity
457:hyperechoic
453:endometrium
432:(TVUS) and
320:pathologist
308:eicosanoids
198:Infertility
95:menorrhagia
72:endometrium
68:Adenomyosis
27:Adenomyosis
3614:Vulvodynia
3498:Enterocele
3448:Vaginismus
3370:Leukorrhea
3278:Cervicitis
3209:Myometrium
3094:Amenorrhea
2920:Oophoritis
2758:DiseasesDB
2672:2024-07-17
2214:Ultrasound
1266:Reprod Sci
1035:Statpearls
1017:References
1006:Adenomyoma
857:See also:
799:amenorrhea
681:Progestins
554:MRI has a
400:Adenomyoma
360:specimen.
249:, and any
111:adenomyoma
76:myometrium
61:20 to 35%.
52:Gynecology
3503:Rectocele
3493:Cystocele
3379:Vaginitis
2798:radio/737
2793:eMedicine
2648:1933-7191
2605:0268-1161
2358:253498672
2342:1469-0705
2234:1742-271X
2177:1469-0705
2122:1469-0705
2056:1469-0705
1908:0952-3278
1524:1355-4786
1384:1471-0528
994:condition
992:(meaning
982:(meaning
972:(meaning
964:The term
960:Etymology
930:Fertility
917:Prognosis
730:infection
706:sterility
623:ibuprofen
606:menopause
596:Treatment
536:Sagittal
411:Diagnosis
269:Mechanism
251:pregnancy
58:Frequency
47:Specialty
3638:Category
3609:Vulvitis
3573:External
3488:Prolapse
3315:Pyometra
2856:Internal
2849:genitals
2613:24622619
2561:17630108
2518:17186255
2480:39831081
2472:24006906
2437:22442261
2396:17707716
2350:36370446
2301:26023602
2252:27433212
2195:34587658
2130:25652685
2064:19291813
2015:24861247
1873:25241270
1821:19644696
1764:24143380
1728:16563870
1649:11139535
1608:16564227
1573:20085913
1532:24140719
1483:16520094
1448:22442261
1400:37765088
1392:17169011
1346:12699258
1294:24041889
1286:24532217
1250:26427702
1168:12351554
1107:26049940
1069:30969690
1043:30969690
1000:See also
627:naproxen
304:estrogen
165:(15–30%)
3304:General
2843:of the
2752:D004715
2292:4437118
2243:4760530
2186:9328356
2072:9986561
1916:1502250
1864:4355446
1812:2730449
1690:9825851
988:), and
875:ovaries
699:Surgery
691:danazol
416:Imaging
3349:Vagina
3250:Cervix
3169:Other
3154:Mixed
3138:Timing
3021:Uterus
2864:Adnexa
2845:pelvis
2787:001513
2741:600458
2646:
2611:
2603:
2559:
2526:228334
2524:
2516:
2478:
2470:
2435:
2394:
2356:
2348:
2340:
2299:
2289:
2250:
2240:
2232:
2193:
2183:
2175:
2138:226070
2136:
2128:
2120:
2070:
2062:
2054:
2013:
1942:
1914:
1906:
1871:
1861:
1819:
1809:
1772:478916
1770:
1762:
1726:
1688:
1647:
1606:
1571:
1530:
1522:
1481:
1446:
1398:
1390:
1382:
1344:
1292:
1284:
1248:
1166:
1105:
1067:
1041:
985:muscle
970:adeno-
879:cervix
877:, and
643:menses
619:NSAIDs
542:uterus
340:cervix
336:vagina
285:serosa
236:Causes
149:anemia
87:menses
3581:Vulva
3548:Other
2873:Ovary
2730:617.0
2715:N80.0
2522:S2CID
2476:S2CID
2354:S2CID
2134:S2CID
2068:S2CID
1981:(PDF)
1768:S2CID
1396:S2CID
1290:S2CID
990:-osis
975:gland
455:as a
225:(11%)
219:(50%)
106:basal
3121:Pain
3089:Flow
2847:and
2747:MeSH
2736:OMIM
2725:9-CM
2644:ISSN
2609:PMID
2601:ISSN
2557:PMID
2514:PMID
2468:PMID
2433:PMID
2392:PMID
2346:PMID
2338:ISSN
2297:PMID
2248:PMID
2230:ISSN
2191:PMID
2173:ISSN
2126:PMID
2118:ISSN
2060:PMID
2052:ISSN
2011:PMID
1940:ISBN
1912:PMID
1904:ISSN
1869:PMID
1817:PMID
1760:PMID
1724:PMID
1686:PMID
1645:PMID
1604:PMID
1569:PMID
1528:PMID
1520:ISSN
1479:PMID
1444:PMID
1388:PMID
1380:ISSN
1342:PMID
1282:PMID
1246:PMID
1164:PMID
1103:PMID
1065:PMID
1039:PMID
980:myo-
937:and
689:and
625:and
567:and
338:and
231:(7%)
204:and
2763:250
2721:ICD
2706:ICD
2636:doi
2591:doi
2549:doi
2506:doi
2502:276
2460:doi
2423:doi
2384:doi
2328:doi
2287:PMC
2279:doi
2238:PMC
2222:doi
2181:PMC
2165:doi
2108:hdl
2100:doi
2042:doi
2001:hdl
1993:doi
1896:doi
1859:PMC
1851:doi
1847:291
1807:PMC
1799:doi
1795:280
1752:doi
1748:155
1716:doi
1676:doi
1635:doi
1596:doi
1559:doi
1510:doi
1471:doi
1434:doi
1372:doi
1368:114
1334:doi
1309:at
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