Xholli Anjeza, Scovazzi Umberto, Londero Ambrogio Pietro, Evangelisti Giulio, Cavalli Elena, Schiaffino Maria Giulia, Vacca Ilaria, Oppedisano Francesca, Ferraro Mattia Francesco, Sirito Giorgio, Molinari Filippo, Cagnacci Angelo
Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, 16132 Genova, Italy.
Department of Neurology, Rehabilitation, Ophtalmology, Genetics, Maternal and Infant Health (DiNOGMI), 16132 Genova, Italy.
J Clin Med. 2022 Jun 4;11(11):3214. doi: 10.3390/jcm11113214.
The aim of this study was to assess the prevalence of adenomyosis in symptomatic women in relation to the angle of flexion of the uterus. A total of 120 patients referring to our Chronic Pelvic Pain Center were prospectively enrolled. Each woman scored menstrual pain, intermenstrual pain, and dyspareunia on a 10 cm visual analogue scale and underwent a clinical examination and transvaginal ultrasound. MUSA criteria were used for the diagnosis of adenomyosis. The angle of flexion of the uterus on the cervix was categorized as <150° (75% of cases), between 150° and 210° (6.7% of cases) and >210° (18.3% of cases). Adenomyosis was diagnosed in 76/120 women (63.3%). In women with adenomyosis, the VAS of intermenstrual pain was higher than in women without adenomyosis (4.04 ± 3.79 vs. 2.57 ± 3.34; p < 0.034). The angle of uterine flexion >210° was more prevalent in women with than without adenomyosis (25.0% vs. 6.8%; p < 0.015). The odds ratio of suffering from adenomyosis markedly increased in the presence of an angle of uterine flexion >210° (OR 5.8 95% CI 1.19, 28.3; p > 0.029). The data indicate that the ultrasound-estimated angle of uterine flexion >210° is related to a higher prevalence of adenomyosis.
本研究的目的是评估有症状女性中子宫腺肌病的患病率与子宫屈曲角度的关系。前瞻性纳入了总共120名转诊至我们慢性盆腔疼痛中心的患者。每位女性在10厘米视觉模拟量表上对痛经、经间期疼痛和性交困难进行评分，并接受临床检查和经阴道超声检查。采用MUSA标准诊断子宫腺肌病。子宫在宫颈处的屈曲角度分为<150°（75%的病例）、150°至210°之间（6.7%的病例）和>210°（18.3%的病例）。120名女性中有76名（63.3%）被诊断为子宫腺肌病。患有子宫腺肌病的女性经间期疼痛的视觉模拟量表评分高于未患子宫腺肌病的女性（4.04±3.79对2.57±3.34；p<0.034）。子宫屈曲角度>210°在患有子宫腺肌病的女性中比未患子宫腺肌病的女性更常见（25.0%对6.8%；p<0.015）。当子宫屈曲角度>210°时，患子宫腺肌病的优势比显著增加（优势比5.8，95%置信区间1.19，28.3；p>0.029）。数据表明，超声估计的子宫屈曲角度>210°与子宫腺肌病的较高患病率相关。
