子宫腺肌病
医学
不育
产科
放射科
妇科
怀孕
子宫内膜异位症
遗传学
生物
作者
C. Exacoustós,G. Morosetti,Francesca Conway,S. Camilli,Francesco Giuseppe Martire,Lucia Lazzeri,Emilio Piccione,Errico Zupi
标识
DOI:10.1016/j.jmig.2019.09.788
摘要
ABSTRACT
Study Objective
To correlate the type and degree of adenomyosis, scored through a new system based on the features of transvaginal sonography, to patients' symptoms and fertility. Design
This is a multicenter, observational, prospective study. Setting
Two endometriosis tertiary referral centers (University of Rome "Tor Vergata" and University of Siena). Patients
A total of 108 patients with ultrasonographic signs of adenomyosis. Interventions
A new ultrasonographic scoring system designed to assess the severity and the extent of uterine adenomyosis was used to stage the disease in correlation with the clinical symptoms. Menstrual uterine bleeding was assessed by a pictorial blood loss analysis chart, painful symptoms were evaluated using a visual analog scale, and infertility factors were considered. Measurements and Main Results
A total of 108 patients with ultrasonographic signs of adenomyosis (mean age ± standard deviation, 37.7 ± 7.7 years) were classified according to the proposed scoring system. Women with ultrasound diagnosis of diffuse adenomyosis were older (p = .04) and had heavier menstrual bleeding (p = .04) than women with focal disease; however, no statistically significant differences were found regarding the presence and severity of dyspareunia and dysmenorrhea. Higher values of menstrual bleeding were found for severe diffuse adenomyosis, with the highest values being found in those with adenomyomas. In patients trying to conceive, the presence of ultrasound findings of focal disease was associated with a higher percentage of infertility than in those with diffuse disease, and the focal involvement of the junctional zone showed a higher percentage of at least 1 miscarriage than in those with diffuse adenomyosis. Conclusion
The ultrasonographic evaluation of the type and extension of adenomyosis in the myometrium seems to be important in correlation to the severity of symptoms and infertility.
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