Adenomyosis

Posted by e-Medical PPT Monday, September 20, 2010
Adenomyosis (Previously named as endometriosis interna)is the presence of ectopic glandular tissue found in myometrium of the uterus.Adenomyosis actually different from endometriosis and these two disease entities are found together in only 10% of the cases.The condition is typically found in women between the ages of 35 and 50. Patients with adenomyosis can have dysmenorrhea & menorrhagia.However, because the endometrial glands can be trapped in the myometrium, it is possible to have increased pain without increased blood. (This can be used to distinguish adenomyosis from endometrial hyperplasia; in the latter condition, increased bleeding is more common.)
In adenomyosis, basal endometrium penetrates into hyperplastic myometrial fibers. Therefore, unlike functional layer, basal layer does not undergo typical cyclic changes with menstrual cycle.Adenomyosis may involve the uterus focally, creating an adenomyoma. With diffuse involvement, the uterus becomes bulky and heavier.
The cause of adenomyosis is unknown, although it has been associated with any sort of uterine trauma that may break the barrier between the endometrium and myometrium, such as a caesarean section, tubal ligation, pregnancy termination.It can be linked with Endometriosis.
The uterus may be imaged using ultrasound or MRI. Transvaginal ultrasound is the most cost effective and most available. Either modality will show an enlarged uterus.Treatment options range from use of NSAIDS and hormonal suppression for symptomatic relief, with hysterectomy the only permanent cure option. Women with Adenomyosis fail endometrial ablation because the ablation only affects the surface endometrial tissue, not the tissue that has grown into the muscle lining.

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