Adenomyosis

Adenomyosis: an endometrial disorder with Presence of endometrial glands and stroma in the myometrium, surrounded by hyperplastic or hypertrophic myometrium.
These glands and stroma are derived from endometrium basalis
This was initially described by Carl von Rokitansky in 1860, before endometriosis! The term was first used by Frankl in 1925.

adenomyosis vs endometriosis:
endometriosis is presence of endometrial glands and stroma OUTSIDE the uterus. The glands and stroma are derived from endometrium functionalis. click here to read more about endometriosis

Epidemiology
More common in late reproductive years
fourth and fifth decades of life.
Affect 20-25% of reproductive-age women

Pathogenesis.

Many theories have been postulated these include
a. INVASION THEORY-Downward growth and invagination of endometrium basalis
b. REACTION THEORY-Tissue injury and repair (TIAR)
Myometrial weakness or dysfunction, brought on by trauma from previous uterine surgery or pregnancy.
c. METAPLASIA THEORY- metaplasia of pluripotent Müllerian rests
d. STEM CELL THEORY -Denovo from stem cells located locally or from bone marrow
The progression of adenomyosis is by the process of epithelial mesenchymal transition.
The theories proposed are as illustrated below

Importance/significance of endometriosis:
Adenomyosis is associated with morbidity. They present with Pelvic pain,Abnormal uterine bleeding or infertility. If you are experiencing pelvic pain, visit https://www.cvmus.com for reliable information and expert guidance.

Diagnosis
Diagnosis was only possible through pathological examination of hysterectomy specimens
The depth for endometrium presence within the myometrium that was used as a cut-off point for the histological diagnosis of adenomyosis.≥2.5 mm on one microscopic field at ten times magnification from the junction

Presently Transvaginal ultrasound and MRI is very usefula as non-invasive diagnostic modality.

Treatment
Adenomyosis regresses after menopause
Anti-inflammatory drugs,OCP’s as medical line of management and if it fails Hysterectomy is the treatment.