Gamze YILMAZ, EMRE ERDEM TAŞ, AYŞE FİLİZ YAVUZ

Risk of adenomyosis according to the type of previous uterine surgery

This study aimed to ascertain whether previous uterine surgery has a role in the etiology of adenomyosis; to determine the incidence of uterine surgery in adenomyosis cases; and to assess the risk of adenomyosis according to the type of uterine surgery. The study included 1481 patients who had a hysterectomy due to any indication in a single center between January 2004 and December 2014. It was approved by the Ethical Rewiew Board of Ankara Yildirim Beyazit University Faculty of Medicine. Patients with and without adenomyosis were divided into two groups and compared according to age, parity, and history of previous uterine surgery. Previous uterine surgeries were also separately compared. A p-value less than 0.05 was considered statistically significant.We found that 63.4% of adenomyosis patients and 40.6% of non-adenomyosis patients underwent at least one uterine surgery. In patients with similar age and parity, those who underwent a uterine surgery were 2.494 times more at risk of being diagnosed with adenomyosis. A separate analysis of surgeries showed that previous myomectomy and Dilatation and Curetege were associated with an increased risk of adenomyosis while Cesarean-section had no significant effect. It was observed that previous uterine surgeries increase the risk for adenomyosis. Patients who had one more uterine surgery were more likely to develop adenomyosis.

PDF

___

Siegler AM ,Camilien L. Adenomyosis J Reprod Med. 1994:39; 841-53.

Hendrickson MR, Kempson RL. Non-neoplastic conditions of the myometrium and uterine serosa H. Fox (Ed.), Haines and Taylor obstetrical and gynecological pathology (3rd edition), Churchill Livingstone, Edinburgh, London, Melbourne and New York (1987), pp. 405-10.

Parazzini F, Vercellini P, Panazza S,et al. Risk factors for adenomyosis. Hum Reprod. 1997;12:1275-9.

Bergholt T, Eriksen L, Berendt N, et al. Prevalence and risk factors of adenomyosis at hysterectomy. Hum Reprod. 2001;16: 2418-21.

Vercellini P, Vigano P, Somigliana,et al. Adenomyosis: epidemiological factors. Best Pract Res Clin Obstet Gynaecol. 2006;20:465-77.

Parazzini F, Mais V, Cipriani S,et al. Determinants of adenomyosis in women who underwent hysterectomy for benign gynecological conditions: results from a prospective multicentric study in Italy. Eur J Obstet Gynecol Reprod Biol. 2009;143:103-6.

Taran FA,Weaver AL, Coddington CC,et al. Understanding adenomyosis: a case control study. Fertil Steril. 2010; 94: 1223-8.

Taran FA,Wallwiener M, Kabashi D, et al. Clinical characteristics indicating adenomyosis at the time of hysterectomy: a retrospective study in 291 patients. Arch Gynecol Obstet. 2012;285:1571–6.

Templeman C, Marshall SF, Ursin G, et al. Adenomyosis and endometriosis in the California Teachers Study. Fertil Steril. 2008; 90:415-24.

Panganamamula UR, Harmanlı OH, Isık -Akbay EF, et al. İs prior uterine surgery a risk factor for adenomyosis. Obstet Gynecol. 20014;104:1034-8.

Kazemi E, Alavi A, Aalinehad Fet al. Evaluation of the relationship between prior uterine surgery and the incidence of adenomyosis in the Shariati Hospital in Bandar-Abbas ,Iran,from 2001 to 2011. Electron Physician. 2014;6:912-8.

Curtis KM, Hillis SD, Marchbanks PA, et al. Disruption of the endometrialmyometrial border during pregnancy as a risk factor for adenomyosis. Am J Obstet Gynecol. 2002;187:543–4.

Farquhar C, Brosens I. Medical and surgical management of adenomyosis. Best Pract Res Clin Obstet Gynaecol 2006;20:603-16.

Vavilis D, Agorastos T, Tzafetas J, et al. Adenomyosis at hysterectomy: prevalence and relationship to operative findings and reproductive and menstrual factors. Clin Exp Obstet Gynecol. 1997;24:36-8.

Whitted R, Verma U, Voigl B, et al. Does cesarean delivery increase the prevalence of adenomyosis? A retrospective review. Obstet Gynecol. 2000;95:S83

Levgur M, Abadi MA, Tucker A. Adenomyosis: symptoms, histology, and pregnancy terminations.Obstet Gynecol. 2000;95:688-91.