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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) [26].”
From Using artificial intelligence to semi-automate trustworthiness assessment of randomized controlled trials: a case study (2025) · cites this paper as [26]
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“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]
Experimental — accuracy not yet measuredIn the citing paper
“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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Citations
Cites
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Cited by
Sorted by citations
Diagnosing adenomyosis: an integrated clinical and imaging approach
Chapron, C., Vannuccini, S., Santulli, P., Abrão, M. S., Carmona, F., Fraser, I. S., Gordts, S., Guo, S., Just, P., Noël, J., et al. (2020) · Human Reproduction Update · doi:10.1093/humupd/dmz049 · Cited by 439
RETIRED: No. 345-Primary Dysmenorrhea Consensus Guideline
Burnett, M. A., & Lemyre, M. (2017) · Journal of Obstetrics and Gynaecology Canada · doi:10.1016/j.jogc.2016.12.023 · Cited by 365
Adenomyosis: A Clinical Review of a Challenging Gynecologic Condition
Struble, J., Reid, S., & Bedaiwy, M. A. (2015) · Journal of Minimally Invasive Gynecology · doi:10.1016/j.jmig.2015.09.018 · Cited by 323
High-Intensity Focused Ultrasound: A Review of Mechanisms and Clinical Applications
Bachu, V., Kedda, J., Suk, I., Green, J., & Tyler, B. (2021) · Annals of Biomedical Engineering · doi:10.1007/s10439-021-02833-9 · Cited by 271
Recent advances in understanding and managing adenomyosis
Vannuccini, S., & Petraglia, F. (2019) · F1000Research · doi:10.12688/f1000research.17242.1 · Cited by 298
Metadata
- 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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