Differences clinical characteristics and factors in intrinsic and extrinsic adenomyosis

Abstract

AbstractAdenomyosis (AM) is a common gynecological condition that can be classified into different subtypes. This study aimed to evaluate the clinical characteristics, factors and treatment effect in women who diagnosed with intrinsic or extrinsic AM by MRI and underwent hysterectomies. A total of 181 women were enrolled in the study. Among these, 77 of which were identified to be in the intrinsic AM group (intrinsic group) and 54 in the extrinsic AM group (extrinsic group). Our results show that gravidity (P < 0.0001), parity (P < 0.0001), number of abortion (P < 0.0013) and endometrial curettage (P = 0.0167) were significantly higher in the intrinsic group, while the education level was lower in the intrinsic group (P = 0.0118). Women in the extrinsic group had earlier menarches (P = 0.0257) and were more coexist with ovarian endometrioma (OMA) (P < 0.0001) and deep infiltrating endometriosis (DIE) (P < 0.0001). In terms of clinical features, dysmenorrhea was more serious in the extrinsic group (P = 0.0091), whereas women in the intrinsic group had heavier menstrual volume (P < 0.0001). Surgery duration (P < 0.0001), surgical bleeding (P < 0.0013), hospitalization cost (P < 0.0001), and postoperative medical therapy (P < 0.001) were significantly higher in the extrinsic group than in the intrinsic group. In the multivariate analysis we performed, education level, gravidity and number of endometrial curettage were significantly associated with intrinsic AM. OMA and DIE were closely related to extrinsic AM. These results suggest that intrinsic and extrinsic AM have specific clinic characteristics, are associated with different factors, and may have different pathogenesis.