2023, Number 08
Adenomyosis: a look at this complex gynecological pathology
Language: Spanish
References: 19
Page:
PDF size: 214.09 Kb.
ABSTRACT
Adenomyosis corresponds to a benign gynecological pathology, which frequently occurs in female patients, where an invasion of the myometrium by the endometrium occurs causing microscopic and macroscopic changes in the uterus. The incidence and prevalence are difficult to estimate, however, it affects approximately 35% of women, this in relation to risk factors. There are multiple theories of why this pathology occurs, among the relevant ones are embryonic intussusception, presence of metalloproteinases, alteration in the modulation of estrogen and progestin receptors and others. The predominant signs and symptoms are dysmenorrhea and abnormal uterine bleeding. To have an accurate diagnosis, a biopsy is performed after hysterectomy; however, in nowdays the ultrasound (US) and nuclear magnetic resonance (MRI) are useful tools for diagnosis. Currently the treatment of choice corresponds to hysterectomy, on the other hand there are alternatives in case the patient wants to continue with the desire to reproduce. The prognosis is individualized and uncertain according to each patient.REFERENCES
Bulun SE, Yildiz S, Adli M, Wei JJ. Adenomyosis pathogenesis: insights from next-generation sequencing. Hum Reprod Update [Internet]. 18 octubre 2021 [citado el 15 marzo 2023];27(6):1086-1097. DOI: 10.1093/humupd/dmab017. PMID:34131719. Disponible en: https://academic.oup.com/humupd/article/27/6/1086/6299969?login=false
A.M. Alcalde, M.A. Martínez-Zamora, F. Carmona. Adenomiosis. Una gran desconocida: ¿Qué debemos saber?. Clínica e Investigación en Ginecología y Obstetricia [Internet]. 2021 [citado el 15 marzo 2023]; 48 (2): 184-189. Disponible en: https://www.sciencedirect.com/science/article/pii/S0210573X20300836
Nougaret S, Cunha TM, Benadla N, Neron M, Robbins JB. Benign Uterine Disease: The Added Role of Imaging. Obstet Gynecol Clin North Am [Internet]. Marzo 2021[citado el 15 marzo 2023];48(1):193-214. DOI: 10.1016/j.ogc.2020.12.002. PMID: 33573786. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0889854520301121?via%3Dihub
Upson K, Missmer SA. Epidemiology of Adenomyosis. Semin Reprod Med [Internet]. Mayo 2020 [citado el 15 marzo 2023];38(2-03):89-107. DOI: 10.1055/s-0040-1718920. Epub 2020 Oct 26. PMID: 33105509; PMCID: PMC7927213. Disponible en: https://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0040-1718920
Arellano Pichardo Edgar Iván, Labastida Torres Jacobo. Prevalencia de adenomiosis en piezas quirúrgicas de histerectomía y factores de riesgo clínicos relacionados. Acta méd. Grupo Ángeles [Internet]. Marzo 2018 [citado el 15 marzo 2023];16(1):15-22. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1870-72032018000100015&lng=es
Galicia Téllez Lilian Nataly, Gómez Pérez María Guadalupe. Prevalencia de adenomiomas y hallazgos asociados en estudios de resonancia magnética de útero en pacientes con miomatosis. Acta méd. Grupo Ángeles [Internet]. Mar 2022 [citado el 15 marzo 2023]; 20(1):24-29. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S1870-72032022000100024&lng=es
Antero MF, Ayhan A, Segars J, Shih IM. Pathology and Pathogenesis of Adenomyosis. Semin Reprod Med [Internet]. May 2020 [citado el 15 marzo 2023];38(2-03):108-118. DOI: 10.1055/s-0040-1718922. Epub 2020 Oct 20. PMID: 33080632; PMCID: PMC7987203. Disponible en: https://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0040-1718922
Li C, Chen R, Jiang C, Chen L, Cheng Z. Correlation of LOX‑5 and COX‑2 expression with inflammatory pathology and clinical features of adenomyosis. Mol Med Rep [Internet]. Enero 2019 [citado el 15 marzo 2023];19(1):727-733. DOI: 10.3892/mmr.2018.9618. Epub 2018 Nov 1. PMID: 30387822. Disponible en: https://www.spandidos-publications.com/10.3892/mmr.2018.9618
Marquardt RM, Jeong JW, Fazleabas AT. Animal Models of Adenomyosis. Semin Reprod Med [Internet]. Mayo 2020 [citado el 15 marzo 2023];38(2-03):168-178. DOI: 10.1055/s-0040-1718741. Epub 2020 Oct 26. PMID: 33105508; PMCID: PMC8054228. Disponible en: https://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0040-1718741
Gnecco JS, Brown AT, Kan EL, Baugh L, Ives C, Loring M, Griffith LG. Physiomimetic Models of Adenomyosis. Semin Reprod Med [Internet]. Mayo 2020 [citado el 15 marzo 2023];38(2-03):179-196. DOI: 10.1055/s-0040-1719084. Epub 2020 Nov 9. PMID: 33176387; PMCID: PMC7803459. Disponible en: https://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0040-1719084
Bourdon M, Santulli P, Marcellin L, Maignien C, Maitrot-Mantelet L, Bordonne C, Plu Bureau G, Chapron C. Adenomyosis: An update regarding its diagnosis and clinical features. J Gynecol Obstet Hum Reprod[Internet]. Diciembre 2021 [citado el 15 marzo 2023];50(10):102228. DOI: 10.1016/j.jogoh.2021.102228. Epub 2021 Sep 11. PMID: 34520877. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S2468784721001653?via%3Dihub
Liu L, Li W, Leonardi M, Condous G, Da Silva Costa F, Mol BW, Wong L. Diagnostic Accuracy of Transvaginal Ultrasound and Magnetic Resonance Imaging for Adenomyosis: Systematic Review and Meta-Analysis and Review of Sonographic Diagnostic Criteria. J Ultrasound Med [Internet]. Noviembre 2021 [citado el 15 marzo 2023];40(11):2289-2306. DOI: 10.1002/jum.15635. Epub 2021 Jan 27. PMID: 33502767. Disponible en: https://onlinelibrary.wiley.com/doi/10.1002/jum.15635
Harmsen MJ, Van den Bosch T, de Leeuw RA, Dueholm M, Exacoustos C, Valentin L, Hehenkamp WJK, Groenman F, De Bruyn C, Rasmussen C, Lazzeri L, Jokubkiene L, Jurkovic D, Naftalin J, Tellum T, Bourne T, Timmerman D, Huirne JAF. Consensus on revised definitions of Morphological Uterus Sonographic Assessment (MUSA) features of adenomyosis: results of modified Delphi procedure. Ultrasound Obstet Gynecol [Internet]. Jul 2022 [citado el 15 marzo 2023];60(1):118-131. DOI: 10.1002/uog.24786. PMID: 34587658; PMCID: PMC9328356. Disponible en: https://obgyn.onlinelibrary.wiley.com/doi/10.1002/uog.24786
Tellum T, Matic GV, Dormagen JB, Nygaard S, Viktil E, Qvigstad E, Lieng M. Diagnosing adenomyosis with MRI: a prospective study revisiting the junctional zone thickness cutoff of 12 mm as a diagnostic marker. Eur Radiol [Internet]. Diciembre 2019 [citado el 15 marzo 2023];29(12):6971-6981. DOI: 10.1007/s00330-019-06308-3. Epub 2019 Jul 1. PMID: 31264010. Disponible en: https://link.springer.com/article/10.1007/s00330-019-06308-3
Management of Acute Abnormal Uterine Bleeding in Nonpregnant Reproductive-Aged Women. Women Health Care Physicians[Internet]. The American College of Obstetricians and Gynecologist. 2013 [citado el 15 marzo 2023]; 557. Disponible en: https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/04/management-of-acute-abnormal-uterine-bleeding-in-nonpregnant-reproductive-aged-women
Stratopoulou CA, Donnez J, Dolmans MM. Conservative Management of Uterine Adenomyosis: Medical vs. Surgical Approach. J Clin Med [Internet]. 22 octubre 2021 [citado el 15 marzo 2023];10(21):4878. DOI: 10.3390/jcm10214878. PMID: 34768397; PMCID: PMC8584979. Disponible en: https://www.mdpi.com/2077-0383/10/21/4878
Wu Q, Lian Y, Chen L, Yu Y, Lin T. Alleviation of Symptoms and Improvement of Endometrial Receptivity Following Laparoscopic Adenomyoma Excision and Secondary Therapy with the Levonorgestrel-releasing Intrauterine System. Reprod Sci [Internet]. Junio 2020 [citado el 15 marzo 2023];27(6):1259-1265. DOI: 10.1007/s43032-019-00130-4. Epub 2020 Jan 6. PMID: 32046429. Disponible en: https://link.springer.com/article/10.1007/s43032-019-00130-4