Adenomyosis: epidemiology, risk factors, clinical phenotype and surgical and interventional alternatives to hysterectomy
Open accessAbstract
Adenomyosis is an important clinical challenge in gynecology and healthcare economics; in its fully developed form, hysterectomy is often used to treat it in premenopausal and perimenopausal women. Symptoms of adenomyosis typically include menorrhagia, pelvic pain and dysmenorrhea. Moreover, adenomyosis and leiomyomas commonly coexist in the same uterus, and differentiating the symptoms for each pathological process can be problematic. Although it has been recognized for over a century, reliable epidemiological studies on this condition are limited, because only postoperative diagnoses were possible in the past. Minimally invasive surgical techniques (endometrial ablation/resection, myometrial excision/reduction, myometrial electrocoagulation, uterine artery ligation) have had limited success in the treatment of adenomyosis, and the reported data for these procedures have been obtained from case reports or small case series with only short follow-up times. However, newer techniques including uterine artery embolization (UAE) and magnetic resonance imaging guided focused ultrasound (MRgFUS) show promise in treating adenomyosis. The data is strongest for UAE; these studies have the largest patient cohorts. However, none of the UAE studies were randomized or controlled. Thus, despite the clinical importance of adenomyosis, there is little evidence on which to base treatment decisions. The objective of this review is to summarize the epidemiology, risk factors, clinical phenotype and to evaluate the accrued experience with surgical and interventional alternatives to hysterectomy.
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In Table 1 of the publication, women's age and symptoms have been reported (chronic pelvic pain, dysmenorrhea, metrorrhagia, dyspareunia, and subfertility).
“In Table 1 of the publication, women's age and symptoms have been reported (chronic pelvic pain, dysmenorrhea, metrorrhagia, dyspareunia, and subfertility) [26].”
From Using artificial intelligence to semi-automate trustworthiness assessment of randomized controlled trials: a case study (2025) · cites this paper as [26]
Table 1 (page not specified in our copy) reports studies of uterine artery embolization, listing patient counts, numbers with improved symptoms, and follow-up. It does not report women’s ages or the listed symptoms. The paper discusses age and some symptoms elsewhere, but not in Table 1. (LLM, conf=0.90)
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Experimental — accuracy not yet measuredPrognostic factors of adenomyosis include age, multiparity, history of uterine surgery, smoking, ectopic pregnancy, and clinical phenotype symptoms.
“Prognostic factors of adenomyosis include age, multiparity, history of uterine surgery, smoking, ectopic pregnancy, and clinical phenotype symptoms.”
From Using artificial intelligence to semi-automate trustworthiness assessment of randomized controlled trials: a case study (2025) · cites this paper as [26]
The Age and Multiparity sections describe the age distribution and high proportion of multiparous women among those with adenomyosis, while the clinical-phenotype discussion describes presenting symptoms. But the Prior uterine surgery section calls that risk factor uncertain, the Smoking section calls the association controversial, and the Ectopic pregnancy section says that proposed association requires more evidence. The paper discusses risk factors and symptoms, not established prognostic factors as the claim implies; no page numbers were available in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredParity is consistently a risk factor for adenomyosis, while smoking is inconsistently protective.
“Parity is consistently shown to be a risk factor, while smoking is inconsistently shown to be a protective factor [15,18].”
From The Pathogenesis of Adenomyosis vis-à-vis Endometriosis (2020) · cites this paper as [18]
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- Authors
- Taran, F., Stewart, E., & Brucker, S.
- Affiliations
- University of Tübingen (DE)
- Mayo Clinic (US)
- Corresponding author
- Taran, F.
- Venue
- Geburtshilfe und Frauenheilkunde
- Publisher
- Georg Thieme Verlag KG
- Published
- 2013-10-11
- Volume
- 73
- Issue
- 09
- Pages
- 924-931
- ISSN
- 0016-5751 (ISSN-L)
- 1438-8804
- PMC
- PMC3859152
- OpenAlex
- W2054264645
- Cited by
- 213
- References
- 99
- Citations by year
- 2026: 12 · 2025: 16 · 2024: 23 · 2023: 23 · 2022: 23 · 2021: 22 · 2020: 19 · 2019: 18 · 2018: 12 · 2017: 16 · 2016: 13 · 2015: 11 · 2014: 4
- FWCI
- 11.27
- Type
- journal article
- Language
- de
- Open access
- bronze
- doi.org
- Locations
- Geburtshilfe und Frauenheilkunde (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
- Health Sciences › Medicine › Obstetrics and Gynecology › Gynecological conditions and treatments
- Keywords
- adenomyosis, epidemiology, risk factors, clinical phenotype, uterine artery embolization, MR-guided focused ultrasound, minimally invasive surgery, endometrial ablation, uterine artery ligation, leiomyoma, menorrhagia, dysmenorrhea, pelvic pain, perimenopausal women
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