Filip Gabriele, Balzano Alessandro, Cagnacci Angelo
Institute of Obstetrics and Gynecology, Department of Medical Area, University of Udine, Udine, Italy.
Institute of Obstetrics and Gynecology, Department of Medical Area, University of Udine, Udine, Italy -
Minerva Ginecol. 2019 Jun;71(3):177-181. doi: 10.23736/S0026-4784.18.04291-0. Epub 2018 Nov 27.
The objective of this study is to evaluate the prevalence of adenomyosis, leiomyomas and of their concomitance in women who underwent hysterectomy.
An observational study carried out on a cohort of 347 women who underwent hysterectomy from a sample of 2383 patients who had gynecological surgery for benign disease in a single University Hospital between 2013 and 2016. A histological evaluation of all surgical specimens was carried out for the presence of adenomyosis and leiomyomas. Prevalence of adenomyosis alone, of leiomyomas alone or of their concomitance was evaluated.
In 140 women, indication to hysterectomy was an abnormal uterine bleeding, or pelvic pain (symptomatic), while in the remaining 207 hysterectomy was performed in postmenopausal women for uterine descent or concomitantly to ovariectomy. Mean age of women in the two groups at hysterectomy was 47.7±5.3 years and 68.9±7.9 years, respectively. Prevalence of adenomyosis (40% vs. 27%; P<0.0001) and of leiomyomas (70.7% vs. 50.7%; P<0.0001) was more frequent in symptomatic than post-menopausal women. Concomitant presence of adenomyosis and leiomyomas was also more prevalent in symptomatic than post-menopausal women (30% vs. 14%; P<0.0001). About 75% of the uteri of symptomatic women with adenomyosis had also leiomyomas and 42.4% of those with leiomyomas has also adenomyosis.
In symptomatic women, adenomyosis and leiomyomas are frequent and coexist in 30% of cases. Coexistence of the two pathologies should be considered in women suffering of heavy menstrual bleeding and menstrual pain.
本研究的目的是评估接受子宫切除术的女性中子宫腺肌病、子宫肌瘤及其合并存在的患病率。
对2013年至2016年期间在一家大学医院因良性疾病接受妇科手术的2383例患者样本中的347例行子宫切除术的女性进行了一项观察性研究。对所有手术标本进行组织学评估，以确定是否存在子宫腺肌病和子宫肌瘤。评估单独子宫腺肌病、单独子宫肌瘤或其合并存在的患病率。
140名女性中，子宫切除术的指征是异常子宫出血或盆腔疼痛（有症状），而其余207例子宫切除术是在绝经后女性中因子宫脱垂或与卵巢切除术同时进行的。两组女性子宫切除时的平均年龄分别为47.7±5.3岁和68.9±7.9岁。有症状的女性比绝经后女性子宫腺肌病（40%对27%；P<0.0001）和子宫肌瘤（70.7%对50.7%；P<0.0001）的患病率更高。有症状的女性比绝经后女性子宫腺肌病和子宫肌瘤合并存在的情况也更普遍（30%对14%；P<0.0001）。有子宫腺肌病的有症状女性中约75%也有子宫肌瘤，有子宫肌瘤的女性中42.4%也有子宫腺肌病。
在有症状的女性中，子宫腺肌病和子宫肌瘤很常见，30%的病例中两者并存。对于有月经过多和痛经的女性，应考虑这两种病理情况并存。
