Is prior uterine surgery a risk factor for adenomyosis?
Abstract
OBJECTIVE: The objective of our study was to assess whether prior uterine surgery is a risk factor for adenomyosis. METHODS: Medical records of women who had a hysterectomy for benign conditions between January of 1995 and June of 2002 were reviewed. Women with and without adenomyosis were compared with respect to history of prior uterine surgery, such as cesarean delivery, myomectomy, endometrial ablation, dilation and evacuation, and dilation and curettage. RESULTS: Of 873 completed records available, 412 patients (47.1%) had adenomyosis. Mean age and race distribution were similar between the 2 groups. The group with adenomyosis had significantly higher gravidity (P < .001) and parity (P = .004), but smaller uterine size (P < .001) and uterine weight (P < .001). Univariable analysis for each aforementioned specific surgical procedure did not indicate a significant difference between women with and without adenomyosis. However, history of any prior uterine surgery increased the risk of adenomyosis (48.8% and 41.0%, odds ratio 1.37, 95% confidence interval 1.05-1.79) on univariable analysis. This association remained significant when all of the factors were combined in a multivariable logistic regression model. CONCLUSION: In this study, we found a significantly increased risk of adenomyosis with prior uterine surgery. The absence of significant association with any specific surgical procedure is possibly the result of a smaller number of subjects in each individual group. LEVEL OF EVIDENCE: II-3.
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A history of dilatation and curettage (D&C) procedures is a risk factor for adenomyosis.
“A preponderance of evidence suggests that a history of receiving dilatation and curettage (D&C) procedures is a risk factor for adenomyosis [19,20,21,22].”
From The Pathogenesis of Adenomyosis vis-à-vis Endometriosis (2020) · cites this paper as [22]
The EMID model is consistent with published data showing increased risk of adenomyosis in women with a history of D&C or in multiparous women.
“The model also seems to be consistent with published data, i.e., an increased risk of adenomyosis in women with a history of D&C or in multiparous women [19,20,21,22].”
From The Pathogenesis of Adenomyosis vis-à-vis Endometriosis (2020) · cites this paper as [22]
Cites
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Adenomyosis, epidemiological factors
Vercellini, P., Viganò, P., Somigliana, E., Daguati, R., Abbiati, A., & Fedele, L. (2006) · Best Practice & Research Clinical Obstetrics & Gynaecology · doi:10.1016/j.bpobgyn.2006.01.017 · Cited by 319 · see citing works
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The Pathogenesis of Adenomyosis vis-à-vis Endometriosis
Guo, S.-W. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9020485 · Cited by 165 · see citing works
- Authors
- Panganamamula, U. R., Harmanli, O. H., Isik-Akbay, E. F., Grotegut, C. A., Dandolu, V., & Gaughan, J. P.
- Affiliations
- Temple University (US)
- Corresponding author
- Panganamamula, Uma R.
- Isik-Akbay, Ebru F.
- Grotegut, Chad A.
- Dandolu, Vani
- Venue
- Obstetrics & Gynecology
- Published
- 2004-11
- Volume
- 104
- Issue
- 5, Part 1
- Pages
- 1034-1038
- ISSN
- 0029-7844 (ISSN-L)
- OpenAlex
- W1970187455
- Cited by
- 90
- References
- 7
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 6 · 2023: 9 · 2022: 10 · 2021: 6 · 2020: 5 · 2019: 5 · 2018: 5 · 2017: 3 · 2016: 1 · 2015: 4 · 2014: 5 · 2013: 3 · 2012: 5
- FWCI
- 2.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Obstetrics and Gynecology (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, risk factors, hysterectomy, cesarean section, myomectomy, endometrial ablation, dilatation and curettage, dilation and evacuation, parity, uterine size, uterine weight
- MeSH terms
- Adult, Aged, Aged, 80 and over, Endometriosis, Female, Humans, Hysterectomy, Middle Aged, Retrospective Studies, Risk Factors, Uterine Diseases, Multivariate Analysis, Logistic Models
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