Adenomyosis: An Updated Review on Diagnosis and Classification

Authors

Gaby Moawad, Department of Obstetrics and Gynaecology, The George Washington University Hospital, Washington, DC 20037, USA.
Arrigo Fruscalzo, Department of Obstetrics and Gynecology, HFR-Hòpital Fribourgeois, Chemin des Pensionnats 2-6, 1708 Fribourg, Switzerland.
Youssef Youssef, Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynaecology-Maimonides Medical Center, Brooklyn, NY 11219, USA.
Mira Kheil, Department of Obstetrics & Gynecology, Henry Ford Health, Detroit, MI 48202, USA.
Tala Tawil, Department of Pathology, Henry Ford Health, Detroit, MI 48202, USA.
Jimmy Nehme, Department of Internal Medicine, Henry Ford Health, Detroit, MI 48202, USA.
Paul Pirtea, Department of Obstetrics and Gynaecology and Reproductive Medicine, Hopital Foch-Faculté de Médecine Paris, 92150 Suresnes, France.
Benedetta Guani, Department of Obstetrics and Gynecology, HFR-Hòpital Fribourgeois, Chemin des Pensionnats 2-6, 1708 Fribourg, Switzerland.
Huda Afaneh, Department of Obstetrics and Gynecology, Women's Health Institute, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Jean Marc Ayoubi, Department of Obstetrics and Gynaecology and Reproductive Medicine, Hopital Foch-Faculté de Médecine Paris, 92150 Suresnes, France.
Anis Feki, Department of Obstetrics and Gynecology, HFR-Hòpital Fribourgeois, Chemin des Pensionnats 2-6, 1708 Fribourg, Switzerland.

Document Type

Journal Article

Publication Date

7-21-2023

Journal

Journal of clinical medicine

Volume

12

Issue

14

DOI

10.3390/jcm12144828

Keywords

MRI; abnormal uterine bleeding; adenomyosis; dysmenorrhea; histopathology; imaging; junctional zone; pelvic pain; ultrasound; uterine disorders

Abstract

Adenomyosis is a commonly diagnosed benign condition characterized by the presence of ectopic endometrial glands within the underlying myometrium. The most common presenting signs and symptoms are abnormal uterine bleeding, chronic pelvic pain, and infertility. The clinical relevance of this condition is evident in both medical and surgical care. Histopathology and imaging studies are used for the diagnosis and classification of adenomyosis, which are hallmarks of the advancement of our ability to diagnose adenomyosis. Importantly, the diagnosis and classification of adenomyosis lacks standardization due to the nature of imaging techniques, features of adenomyosis, and the clinical spectrum of adenomyosis. We reviewed the literature to summarize the available classification systems for adenomyosis and highlight the different imaging approaches and histologic criteria used in diagnosis. Despite the high prevalence of the disease, there is no clear consensus on one classification system. We provide a review of some of the classification systems available and discuss their strengths and limitations.

APA Citation

Moawad, Gaby; Fruscalzo, Arrigo; Youssef, Youssef; Kheil, Mira; Tawil, Tala; Nehme, Jimmy; Pirtea, Paul; Guani, Benedetta; Afaneh, Huda; Ayoubi, Jean Marc; and Feki, Anis, "Adenomyosis: An Updated Review on Diagnosis and Classification" (2023). GW Authored Works. Paper 3043.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3043

Department

Obstetrics and Gynecology