ADENOMYOSIS: PREVALENCE IN HYSTERECTOMY SPECIMENS WITH CLINICAL REVIEW

Adenomyosis is the existence of ectopic endometrial glands and stroma within the myometrium with myometrial hypertrophy and hyperplasia. The aims of the study are, first, to determine the prevalence of adenomyosis among hysterectomy specimens. Second, to assess the clinical presentation of those patients and other pathologies coexistent in the same uterus. This is a cross-sectional study which was conducted among women, who underwent hysterectomy for various indications in a referral governmental hospital in Sana'a-Yemen. The diagnosis of adenomyosis was confirmed by postoperative histopathological assessment. Out of 73 patients who underwent a total hysterectomy, histopathological results were available for only 50 respondents. Among these patients, 52% were confirmed with a postoperative diagnosis of adenomyosis. At the time of the hysterectomy, 96.15% of patients were aged between 40-50 years old. Adenomyosis was found in 84.62% of grand multiparous women and 57.69% of patients had a history of miscarriages, 88.46% had heavy menstrual bleeding, 61.54% had dysmenorrhea and those with chronic pelvic pain were 61.54%. Based on histopathological findings, uterine leiomyoma and endometrial hyperplasia were 26.92% each and those with endometrial inflammation and cervical ectropion were 34.62% and 30.77% respectively. Although the preoperative diagnosis of adenomyosis was rare among our candidates, more than half of them had the disease in the hysterectomy specimen. The common clinical features of adenomyosis and the presence of other pathologies in the same uterus can conceal its diagnosis. Through this study, we want to bring awareness of the high prevalence of adenomyosis in this region.