Prevalence and risk factors of adenomyosis at hysterectomy

BACKGROUND: The present study was performed to evaluate the prevalence and possible associated risk factors for adenomyosis. METHODS: Medical records were retrieved and histo-pathological material re-examined for 549 consecutive women undergoing hysterectomy in a two-year period from 1990-1991. RESULTS: The prevalence of adenomyosis in the study varied from 10.0-18.2%, depending on different diagnostic criteria. The presence of endometrial hyperplasia at the time of hysterectomy was the only variable significantly associated with adenomyosis (OR = 3.0; 95% CI: 1.2-8.3). No statistically significant association was found between adenomyosis and previous caesarean section, endometrial curettage or evacuation of the uterus. Furthermore, we did not see any significant association between adenomyosis and pain-related symptoms, indication for hysterectomy, age, parity or number of myometrial samples. CONCLUSIONS: Our study stresses the need for precise diagnostic criteria for adenomyosis, and furthermore indicates that endometrial hyperplasia and adenomyosis may have a common aetiology.