Incidence of adenomyosis in hysterectomy patients higher than previously reported

 

NATIONAL HARBOR, MD – Patients who experience chronic pelvic pain have higher rates of adenomyosis than previously thought, suggest new findings presented at the AAGL Global Congress.

Samantha P. Nadella, MD, and her associates conducted a retrospective cohort study analyzing 101 women with chronic pelvic pain who underwent hysterectomy between April 2014 and December 2016. In total, 51 patients (50.5%) were found to have adenomyosis. Previous studies of adenomyosis had suggested an overall incidence rate of 20%-35%. Dr. Nadella, currently of Kaiser Permanente South Bay Medical Center in Harbor City, Calif., conducted the study during her fellowship in minimally invasive gynecology surgery at St. Joseph’s Hospital and Medical Center in Phoenix.

In the adenomyosis group, there were higher proportions of smokers (37.3%) and patients with a history of cesarean delivery (12.5%). Additionally, women who reported deep pain during intercourse or heavy menstrual bleeding were 1.6 and 13.4 times more likely to have adenomyosis, respectively. Conversely, the presence of adenomyosis dropped by 87% in patients found to have irritable bowel syndrome.

“Anytime women have pelvic pain, or abdominal pain, they are always sent to their gynecologist,” Dr. Nadella said in an interview. However, there are many disorders that may present with pelvic pain but are not related to uterine pathology, including pelvic floor muscle dysfunction, interstitial cystitis, and irritable bowel syndrome. As suggested in this study, pelvic pain is frequently present in patients with IBS, both with and without adenomyosis.

“When we’re talking about hysterectomy and surgical management for pelvic pain, we need to do our due diligence to make sure we are not missing more treatable disorders, especially those with conservative treatments,” Dr. Nadella said. “It is important to counsel patients who are undergoing surgery for pelvic pain by explaining what will happen and what they can expect, including postsurgical pain and need for ongoing treatments. Additionally, cross-disciplinary communication is key in delivering more effective and personalized treatment of pelvic pain.”

Dr. Nadella reported having no financial disclosures.

ilacy@frontlinemedcom.com

 

NATIONAL HARBOR, MD – Patients who experience chronic pelvic pain have higher rates of adenomyosis than previously thought, suggest new findings presented at the AAGL Global Congress.

Samantha P. Nadella, MD, and her associates conducted a retrospective cohort study analyzing 101 women with chronic pelvic pain who underwent hysterectomy between April 2014 and December 2016. In total, 51 patients (50.5%) were found to have adenomyosis. Previous studies of adenomyosis had suggested an overall incidence rate of 20%-35%. Dr. Nadella, currently of Kaiser Permanente South Bay Medical Center in Harbor City, Calif., conducted the study during her fellowship in minimally invasive gynecology surgery at St. Joseph’s Hospital and Medical Center in Phoenix.

In the adenomyosis group, there were higher proportions of smokers (37.3%) and patients with a history of cesarean delivery (12.5%). Additionally, women who reported deep pain during intercourse or heavy menstrual bleeding were 1.6 and 13.4 times more likely to have adenomyosis, respectively. Conversely, the presence of adenomyosis dropped by 87% in patients found to have irritable bowel syndrome.

“Anytime women have pelvic pain, or abdominal pain, they are always sent to their gynecologist,” Dr. Nadella said in an interview. However, there are many disorders that may present with pelvic pain but are not related to uterine pathology, including pelvic floor muscle dysfunction, interstitial cystitis, and irritable bowel syndrome. As suggested in this study, pelvic pain is frequently present in patients with IBS, both with and without adenomyosis.

“When we’re talking about hysterectomy and surgical management for pelvic pain, we need to do our due diligence to make sure we are not missing more treatable disorders, especially those with conservative treatments,” Dr. Nadella said. “It is important to counsel patients who are undergoing surgery for pelvic pain by explaining what will happen and what they can expect, including postsurgical pain and need for ongoing treatments. Additionally, cross-disciplinary communication is key in delivering more effective and personalized treatment of pelvic pain.”

Dr. Nadella reported having no financial disclosures.

ilacy@frontlinemedcom.com

 

NATIONAL HARBOR, MD – Patients who experience chronic pelvic pain have higher rates of adenomyosis than previously thought, suggest new findings presented at the AAGL Global Congress.

Samantha P. Nadella, MD, and her associates conducted a retrospective cohort study analyzing 101 women with chronic pelvic pain who underwent hysterectomy between April 2014 and December 2016. In total, 51 patients (50.5%) were found to have adenomyosis. Previous studies of adenomyosis had suggested an overall incidence rate of 20%-35%. Dr. Nadella, currently of Kaiser Permanente South Bay Medical Center in Harbor City, Calif., conducted the study during her fellowship in minimally invasive gynecology surgery at St. Joseph’s Hospital and Medical Center in Phoenix.

In the adenomyosis group, there were higher proportions of smokers (37.3%) and patients with a history of cesarean delivery (12.5%). Additionally, women who reported deep pain during intercourse or heavy menstrual bleeding were 1.6 and 13.4 times more likely to have adenomyosis, respectively. Conversely, the presence of adenomyosis dropped by 87% in patients found to have irritable bowel syndrome.

“Anytime women have pelvic pain, or abdominal pain, they are always sent to their gynecologist,” Dr. Nadella said in an interview. However, there are many disorders that may present with pelvic pain but are not related to uterine pathology, including pelvic floor muscle dysfunction, interstitial cystitis, and irritable bowel syndrome. As suggested in this study, pelvic pain is frequently present in patients with IBS, both with and without adenomyosis.

“When we’re talking about hysterectomy and surgical management for pelvic pain, we need to do our due diligence to make sure we are not missing more treatable disorders, especially those with conservative treatments,” Dr. Nadella said. “It is important to counsel patients who are undergoing surgery for pelvic pain by explaining what will happen and what they can expect, including postsurgical pain and need for ongoing treatments. Additionally, cross-disciplinary communication is key in delivering more effective and personalized treatment of pelvic pain.”

Dr. Nadella reported having no financial disclosures.

ilacy@frontlinemedcom.com