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Am Fam Physician 2019 Apr;99(7):435-443

University of North Carolina School of Medicine, Chapel Hill, NC, USA.

Abnormal uterine bleeding is a common symptom in women. The acronym PALM-COEIN facilitates classification, with PALM referring to structural etiologies (polyp, adenomyosis, leiomyoma, malignancy and hyperplasia), and COEIN referring to nonstructural etiologies (coagulopathy, ovulatory dysfunction, endometrial, iatrogenic, not otherwise classified). Evaluation involves a detailed history and pelvic examination, as well as laboratory testing that includes a pregnancy test and complete blood count. Read More

Fertil Steril 2019 Apr;111(4):629-640

Department of Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, California; Department of Obstetrics and Gynecology, Kaiser-Permanente, Los Angeles Medical Center, Los Angeles, California. Electronic address:

Endometrial polyps, adenomyosis, and leiomyomas are commonly encountered abnormalities frequently found in both fertile women and those with infertility. The clinician is frequently challenged to determine which of these entities, when found, is likely to impair fertility, and which are "innocent bystanders" unrelated to the problem at hand. Although removing an endometrial polyp may be seen as a relatively benign and safe intervention, myomectomy, and in particular adenomyomectomy, can be substantive surgical procedures, associated with their own potential for disrupting fertility. Read More

Radiol Clin North Am 2019 May 14;57(3):601-616. Epub 2019 Feb 14.

Department of Radiology, Mayo Clinic Arizona, Phoenix, AZ 85054, USA.

Pelvic ultrasound with endovaginal ultrasound is often the imaging test of choice in the initial evaluation of nonpregnant women with pelvic pain. This article considers the sonographic observations and techniques useful in diagnosis of a variety of gynecologic causes of pelvic pain in these women, including ovarian hemorrhage, ovarian torsion, pelvic inflammatory disease, endometriosis (particularly deeply infiltrating endometriosis), endometriomas, adenomyosis, pelvic congestion syndrome, and malpositioned intrauterine contraceptive devices. Sonographic observations regarding a number of non-gynecologic causes of pelvic pain are also described. Read More

West Afr J Med 2019 Jan-Apr;36(1):88-92

Department of Histopathology, Jos University Teaching Hospital, Jos, Plateau State, Nigeria.

Background: Adenomyosis is defined by the presence within the myometrium of benign endometrial glands and stroma. Several theories have evolved to explain the pathogenesis of adenomyosis. A third of adenomyosis cases are asymptomatic. Read More

F1000Res 2019 13;8. Epub 2019 Mar 13.

Obstetrics and Gynecology, Department of Maternity and Child Health, University Hospital Florence, Careggi University Hospital, Florence, Largo Brambilla 3, 50134, Italy.

Adenomyosis is a benign uterine disorder in which endometrial glands and stroma are pathologically demonstrated in the uterine myometrium and it is considered a specific entity in the PALM-COEIN FIGO (polyp; adenomyosis; leiomyoma; malignancy and hyperplasia; coagulopathy; ovulatory dysfunction; endometrial; iatrogenic; and not yet classified - International Federation of Gynecology and Obstetrics) classification of causes of abnormal uterine bleeding (AUB). Although it has always been considered the classic condition of multiparous women over 40 years old who have pain and heavy menstrual bleeding, diagnosed at hysterectomy, the epidemiological scenario has completely changed. Adenomyosis is increasingly identified in young women with pain, AUB, infertility, or no symptoms by using imaging techniques such as transvaginal ultrasound and magnetic resonance. Read More

World J Clin Cases 2019 Mar;7(5):676-683

Department of Obstetrics and Gynecology, the First Hospital of Jilin University, Changchun 130021, Jilin Province, China.

Background: Cystic adenomyosis is a special type of adenomyosis. Its clinical manifestations lack specificity. Pelvic ultrasound and nuclear magnetic resonance imaging can help clarify the diagnosis. Read More

Abdom Radiol (NY) 2019 Apr;44(4):1256-1260

Department of Radiology, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan.

Tuberous sclerosis complex (TSC), a rare autosomal dominant neurocutaneous disorder, is characterized by the presence of benign congenital tumors in multiple organs. Neoplasms with perivascular epithelioid cell differentiation (PEComas), including angiomyolipoma (AML) and lymphangioleiomyomatosis (LAM), can occur in association with TSC. This report describes two cases of uterine PEComas presenting characteristic MR imaging features reflecting pathological findings. Read More

Am Surg 2018 Oct;84(10):1670-1674

Department of Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California, USA.

The finding of gallbladder polyps on imaging studies prompts further workup. Imaging results are often discordant with final pathology. The goal of this study is to compare polypoid lesions of the gallbladder found on preoperative ultrasound (US) with final pathologic diagnosis after cholecystectomy to help guide clinical decision-making. Read More

Mayo Clin Proc 2019 Feb;94(2):326-335

Division of Obstetrics and Gynecology, Mayo Clinic, Rochester, MN.

Abnormal uterine bleeding (AUB) is a common condition that leads to increased health care costs and decreased quality of life. A systematic approach to AUB evaluation can simplify management and enhance women's well-being. Abnormal uterine bleeding describes any variation from normal bleeding patterns in nonpregnant, reproductive-aged women beyond menarche lasting for at least 6 months. Read More

J Clin Imaging Sci 2018 12;8:55. Epub 2018 Dec 12.

Department of Urology, MIOT Hospitals, Chennai, Tamil Nadu, India.

Inadvertent placement of the urinary catheter into the ureter can cause several complications. We describe a rare complication during cystogram due to unrecognized inadvertently placed urinary catheter in ureter, resulting in a life-threatening situation. A 47-year-old multiparous female underwent total laparoscopic hysterectomy for adenomyosis. Read More

Int J Gynecol Cancer 2019 Jan;29(1):119-125

Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.

Objectives: To describe sonographic features of the microcystic elongated and fragmented (MELF) pattern of myometrial invasion (MI) using the International Endometrial Tumor Analysis (IETA) criteria; to assess the effect of the MELF pattern on preoperative ultrasound evaluation of MI; and to determine the relationship of the MELF pattern to more advanced stage (≥ IB) and lymph node metastases (LNM) in women with endometrioid endometrial cancer (EEC).

Methods/materials: We included 850 women with EEC from the prospective IETA 4 study. Ultrasound experts performed all ultrasound examinations, accordingto the IETA protocol. Read More

J Magn Reson Imaging 2019 Jan 5. Epub 2019 Jan 5.

Department of Radiology, Stanford University, Stanford, California, USA.

Background: Pelvic ultrasound (US) diagnosis of uterine fibroids may overlook coexisting gynecological conditions that contribute to women's symptoms.

Purpose: To determine the added value of pelvic MRI for women diagnosed with symptomatic fibroids by US, and to identify clinical factors associated with additional MRI findings.

Study Type: Retrospective observational study. Read More

Reprod Sci 2019 02 5;26(2):198-206. Epub 2018 Dec 5.

1 Department of Gynaecology Obstetrics II and Reproductive Medicine, Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Universitaire Paris Centre, Centre Hospitalier Universitaire (CHU) Cochin, Paris, France.

Background: Adenomyosis (ADE) is an enigmatic uterine disorder. Several types have been previously described: diffuse adenomyosis (DIF-ADE), focal adenomyosis (FOC-ADE), and association of focal and diffuse lesions (FOC/DIF-ADE). Abnormal immune phenomena have been described that may provide an understanding of the pathophysiology of adenomyosis. Read More

J Obstet Gynaecol Can 2018 Nov;40(11):e788-e836

Calgary, Alb.

Objectif: Améliorer La compréhension de la douleur pelvienne chronique (DPC) et fournir des directives cliniques factuelles qui bénéficieront aux fournisseurs de soins de santé primaires, aux obstétriciens-gynécologues et aux spécialistes de la douleur chronique.

Fardeau De La Souffrance: La DPC est une pathologie débilitante courante qui affecte les femmes. Elle est à l'origine d'importantes souffrances personnelles et de dépenses de santé considérables associées aux interventions, dont de multiples consultations et un grand nombre de traitements médicaux et chirurgicaux. Read More

J Obstet Gynaecol Can 2018 Nov;40(11):e747-e787

Calgary, AB.

Objective: To improve the understanding of chronic pelvic pain (CPP) and to provide evidence-based guidelines of value to primary care health professionals, general obstetricians and gynaecologists, and those who specialize in chronic pain.

Burden Of Suffering: CPP is a common, debilitating condition affecting women. It accounts for substantial personal suffering and health care expenditure for interventions, including multiple consultations and medical and surgical therapies. Read More

Fertil Steril 2018 11;110(6):1154-1161.e3

Department of Biomedicine and Prevention Obstetrics and Gynecological Clinic, University of Rome "Tor Vergata", Rome, Italy. Electronic address:

Objective: To study the interobserver reproducibility of our new ultrasonographic mapping system to define the type and extension of uterine adenomyosis.

Design: Interobserver study involving two observers with different medical backgrounds and gynecological ultrasound experience.

Setting: University hospital. Read More

Diagn Interv Radiol 2018 Nov;24(6):364-371

Department of Radiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.

Purpose: We aimed to identify predisposing factors that could help predict the therapeutic response of adenomyosis after uterine artery embolization (UAE).

Methods: This was a retrospective, single-center study of patients admitted to the hospital for adenomyosis between 2013 and 2015. Sixty-eight patients with adenomyosis who underwent UAE with tris-acryl gelatin microspheres were divided into two groups based on their therapeutic response (complete or incomplete necrosis of lesions), and pre- and postprocedural pelvic magnetic resonance imaging (MRI) data. Read More

Taiwan J Obstet Gynecol 2018 Oct;57(5):753-754

Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. Electronic address:

Objective: Residual ovarian syndrome (ROS) occurs after a hysterectomy in which one or both ovaries have been preserved and cause chronic pelvic pain, an asymptomatic pelvic mass, or dyspareunia. We present a case with classic symptoms and imaging and pathology findings, and review the treatment of residual ovarian syndrome.

Case Report: A 35-year-old woman with a diagnosis of ROS. Read More

Fertil Steril 2018 10;110(5):957-964.e3

Department of Gynecology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.

Objective: To develop a multivariate prediction model for diagnosing adenomyosis using predictors available through transvaginal ultrasonography and clinical examinations.

Design: Prospective observational single-center study.

Setting: Teaching university hospital. Read More

Int J Hyperthermia 2018 11;35(1):626-636. Epub 2018 Oct 11.

c Department of Radiology , Pham Ngoc Thach University of Medicine , Ho Chi Minh City , Viet Nam.

Objective: This retrospective study aimed (1) to investigate the magnetic resonance imaging (MRI) features influencing a nonperfused volume ratio (NPVr) ≥ 90% after high-intensity focussed ultrasound (HIFU) ablation of adenomyosis, and (2) to assess the safety, which was defined in terms of adverse events (AEs) and changes in anti-Mullerian hormone (AMH) concentrations, and clinical efficacy, which was defined in terms of adenomyosis volume reduction and symptom improvement at 6 months' follow-up.

Methods: Sixty-six women who underwent HIFU treatment were divided into groups A (NPVr ≥90%; n = 26) and B (NPVr <90%, n = 40). Multivariate logistic regression analyses of MRI features were conducted to identify the potential predictors of an NPVr ≥90%. Read More

Ultrasound Obstet Gynecol 2018 Oct;52(4):555

Department of Obstetrics & Gynecology, University General Hospital Alexandroupolis, Alexandroupoli, Greece.

J Minim Invasive Gynecol 2018 Sep 28. Epub 2018 Sep 28.

Gynaecology Research Centre, Department of Obstetrics and Gynaecology, The University of Melbourne and Royal Women's Hospital, Parkville, Australia (Drs. Rogers, Holdsworth-Carson, and Girling).

Study Objective: To examine the presence of sonographic evidence of adenomyosis (SEOA) in patients undergoing laparoscopic surgery for the investigation of endometriosis and to assess if there is an association between SEOA and endometriosis severity. Using gene expression analysis, we also aimed to determine if gene expression in eutopic endometria differed in patients with and without adenomyosis.

Design: A prospective study (Canadian Task Force classification II-2). Read More

Gynecol Minim Invasive Ther 2018 Jul-Sep;7(3):119-123. Epub 2018 Aug 23.

Department of Obstetrics and Gynecology, Nippon Medical School, Tokyo, Japan.

Study Objective: The aim of this study is to evaluate the efficacy of hormonal therapies for inhibiting an increase in uterine volume in patients with adenomyosis.

Design: This was retrospective cohort study.

Setting: This study was conducted at Nippon Medical School Musashikosugi Hospital. Read More

Radiographics 2018 Sep-Oct;38(5):1576-1589

From the Department of Radiology, Einstein Healthcare Network, 5501 Old York Rd, Philadelphia, PA 19141.

Adenomyosis is a common benign uterine condition and a frequent cause of pelvic pain in premenopausal women. Transvaginal US is now considered the primary imaging modality for the diagnosis of adenomyosis, and thus radiologists should be familiar with its sonographic appearance. US findings can be divided into three categories, which parallel the histology of adenomyosis: (a) ectopic endometrial glands and stroma, (b) muscular hyperplasia/hypertrophy, and (c) increased vascularity. Read More

Int J Gynaecol Obstet 2018 Dec 10;143(3):393-408. Epub 2018 Oct 10.

School of Women's and Children's Health, Royal Hospital for Women, University of New South Wales, Randwick, NSW, Australia.

Background: The International Federation of Gynecology and Obstetrics (FIGO) systems for nomenclature of symptoms of normal and abnormal uterine bleeding (AUB) in the reproductive years (FIGO AUB System 1) and for classification of causes of AUB (FIGO AUB System 2; PALM-COEIN) were first published together in 2011. The purpose was to harmonize the definitions of normal and abnormal bleeding symptoms and to classify and subclassify underlying potential causes of AUB in the reproductive years to facilitate research, education, and clinical care. The systems were designed to be flexible and to be periodically reviewed and modified as appropriate. Read More

J Minim Invasive Gynecol 2018 Sep 5. Epub 2018 Sep 5.

Service de Chirurgie Gynécologique, (Drs. Collin, Schaub, Faller, Akladios, and Wattiez).

Study Objective: To describe a laparoscopic technique for the resection of deep endometriosis, treating the 3 compartments.

Design: Educational video.

Setting: Tertiary referral center in Strasbourg, France PATIENT: A 37-year-old primiparous woman. Read More

Med Sci Monit 2018 Sep 1;24:6085-6092. Epub 2018 Sep 1.

Department of Obstetrics and Gynecology, The First Affiliated Hospital and Clinical College of Fujian Medical University, Fuzhou, Fujian, China (mainland).

BACKGROUND Adenomyosis is a cause of chronic pelvic pain in women of reproductive age. The aim of this study was to investigate the effects of subcutaneous etonogestrel implantation on adenomyosis. MATERIAL AND METHODS A clinical observational study included 17 women with adenomyosis who were treated with subcutaneous etonogestrel implants and followed-up for 12 months. Read More

Eur Radiol 2019 Mar 29;29(3):1144-1152. Epub 2018 Aug 29.

Radiology Department, Lyon Sud University Hospital, Hospices Civils de Lyon, 165 Chemin du Grand Revoyet, 69495, Pierre Bénite, France.

Objectives: To describe MRI features of accessory cavitated uterine mass (ACUM) with surgical correlations.

Methods: Eleven young women with an ACUM at pathology underwent preoperative pelvic MRI. Two experienced radiologists retrospectively analysed MR images in consensus to determine the lesion location within the uterus, its size, morphology (shape and boundaries), and structure reporting the signal and enhancement of its different parts compared to myometrium. Read More

BMC Neurol 2018 Aug 21;18(1):119. Epub 2018 Aug 21.

Department of Neurology, Faculty of Medicine, Oita University, Yufu-city, Oita, 879-5593, Japan.

Background: Benign gynecologic tumor, such as uterine adenomyosis, has been suggested to develop hypercoagulability. Although some cases of cerebral infarction associated with adenomyosis have been reported, the mechanism of hypercoagulation initiated by adenomyosis is still not clear, and the therapeutic strategy is uncertain.

Case Presentation: A 44-year-old woman was presented to our department with headache, left hand weakness, and gait disturbance during her menstrual phase. Read More

Adv Clin Exp Med 2018 Aug 7. Epub 2018 Aug 7.

Department of Pathophysiology, Jagiellonian University Medical College, Kraków, Poland.

Adenomyosis seems to be the most widespread coexistent pathology included under the umbrella of common benign disorders of the human uterus. The incidence of adenomyosis is under discussion since different imaging criteria are used. In the majority of cases, prevalence is determined among women with uterine fibroids and endometriosis or severe gynecological symptoms. Read More

Eur J Obstet Gynecol Reprod Biol 2018 Sep 12;228:130-136. Epub 2018 Jun 12.

Paul's Hospital, Centre for Advanced Endoscopy & Infertility, Kochi, Kerala, India. Electronic address:

Adenomyosis is the presence of endometrial glands and stroma within the myometrium. The focal and localized form of adenomyosis is known as adenomyoma. It is rarely located outside the uterus which is termed as extrauterine adenomyoma. Read More

Case Rep Oncol 2018 May-Aug;11(2):311-317. Epub 2018 May 29.

Department of Obstetrics and Gynecology, University Hospital Mizonokuchi, Teikyo University School of Medicine, Kawasaki, Japan.

In order to diagnose endometrial cancer preoperatively, outpatient endometrial biopsy with a curette is frequently performed owing to its convenience. However, in some cases, gynecologists fail to diagnose endometrial cancer via outpatient endometrial biopsy because of the cancer's distribution in the uterus and its consistency. A 57-year-old Japanese woman (gravida 4 para 4) presented with a 6-month history of light but intermittent postmenopausal vaginal bleeding. Read More

Cureus 2018 Apr 17;10(4):e2492. Epub 2018 Apr 17.

Department of Surgery, "alexandrovska" University Hospital, Medical University of Sofia, Bulgaria.

A 67-year-old woman presented with clinical symptoms, radiological findings, and preoperative work-up highly suggestive of advanced stage IV carcinoma of the gallbladder (CG). An extended cholecystectomy with the excision of adjacent liver segments and loco-regional lymphadenectomy was performed. Final pathology results revealed diffuse xanthogranulomatous cholecystitis (XG) with ruptured Rokitansky-Aschoff sinuses with tumor-resembling adenomyosis without atypical or malignant cells. Read More

J Med Imaging Radiat Oncol 2018 Oct 19;62(5):649-653. Epub 2018 Jun 19.

Benson Radiology, Adelaide, South Australia, Australia.

Introduction: Pelvic MRI has an increasingly important role in the evaluation of non-malignant uterine pathology including uterine leiomyomas, adenomyosis and endometriosis. Normal physiological myometrial junctional zone transient contractions can also be identified on MRI and have the potential to act as pathology mimics. This study aims to evaluate both the incidence of visible physiological contractions in premenopausal female pelvic MRI and also to support the routine acquisition of a repeat T2 sagittal sequence to differentiate transient physiological contractions from true underlying pathology and therefore improve observer confidence. Read More

Ultrasound Obstet Gynecol 2018 May 22. Epub 2018 May 22.

Department of Gynecology, VU Medical Center, De Boelelaan 1117, 1081HV, Amsterdam, the Netherlands.

Objective: To develop a uniform classification and standardized reporting system of ultrasound findings of adenomyosis using the Morphological Uterus Sonographic Assessment (MUSA) criteria.

Method: The opinion presented in this manuscript was built based on a thorough discussion among all authors, including a Delphi procedure. Selected images and videos of typical cases of the different morphological variations of adenomyosis were used in the debates. Read More

Ultrasound Med Biol 2018 08 18;44(8):1654-1663. Epub 2018 May 18.

Department of Obstetrics and Gynecology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.

The aims of this prospective diagnostic evaluation study were (i) to estimate the inter-observer agreement and reproducibility of real-time sonoelastography and real-time gray-scale ultrasound in the measurement of uterine and fibroid volumes; (ii) to evaluate the agreement between real-time gray-scale ultrasound, sonoelastography and magnetic resonance imaging with respect to these outcomes; and (iii) to evaluate the diagnostic accuracy of sonoelastography in the diagnosis of uterine pathology on stored sonoelastography and gray-scale cine loops. Women without a history of uterine pathology and with the diagnosis intrauterine fibroids or adenomyosis were included. All participants underwent gray-scale ultrasound, sonoelastography and magnetic resonance imaging. Read More

J Ultrasound Med 2019 Jan 6;38(1):149-155. Epub 2018 May 6.

Department of Radiology, University of Michigan, Ann Arbor, Michigan, USA.

Objectives: This study evaluated the diagnostic performance of transvaginal ultrasound (TVUS) shear wave elastography (SWE) for evaluating uterine adenomyosis and leiomyomas.

Methods: Institutional Review Board approval was obtained for prospective enrollment of 34 premenopausal women with pelvic pain and/or bleeding between January 2015 and June 2016. TVUS SWE was performed with regions of interest in multiple uterine segments and shear wave velocities(SWVs) were recorded. Read More

Biomed Res Int 2018 12;2018:2369430. Epub 2018 Mar 12.

West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, China.

In the most recent publications on Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, the uterine remnants and ovaries in patients may develop uterine remnant leiomyoma, adenomyosis, or ovarian tumor, and this can lead to problems in differential diagnosis. Here we summarize the diagnosis methods and available interventions for ovarian tumor in MRKH syndrome, with emphasis on the relevant clinical findings and illustrative relevant case. According to the clinical findings and illustrative relevant case, with the help of imaging techniques, ovarian tumors can be detected in the pelvis in patients with MRKH syndrome and evaluated in terms of size. Read More

Einstein (Sao Paulo) 2018 23;16(1):eMD3863. Epub 2018 Apr 23.

Universidade Federal de São Paulo, São Paulo, SP, Brazil.

Uterine contractility out of the gestational phase, during the menstrual cycle and the habitual functional variations of the organ, this is one of the responsible mechanisms for reproduction and fertility, due to its direct action in the mechanisms conducting the spermatozoa to the ovule and in the decidual implantation. Pathologies such as uterine leiomyoma, endometriosis, adenomyosis, polycystic ovarian syndrome, as well as the use of intrauterine devices and oral contraceptives, may alter a functionality of uterine contractility. Thus, magnetic resonance imaging with ultrafast sequences provides a dynamic evaluation (cine-MRI) and thus the correlation of uterine contractility quality in patients with current infertility or pathologies. Read More

J Ultrasound Med 2018 Dec 24;37(12):2811-2819. Epub 2018 Apr 24.

Clinical Center for Tumor Therapy of the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Objective: To evaluate the clinical usefulness of the microbubble contrast agent SonoVue in enhancing high-intensity focused ultrasound (HIFU) for the treatment of adenomyosis.

Methods: A total of 102 patients with adenomyosis, assessed from August 2015 to April 2017, were randomly divided into 1-minute (A) and 10-minute (B) groups, respectively. In groups A and B, HIFU started 1 minute and 10 minutes, respectively, after SonoVue injection. Read More

Fertil Steril 2018 03;109(3):389-397

Groupe de Recherche Clinique GRC6-UPMC, Centre Expert En Endométriose (C3E), Paris, France; Department of Obstetrics and Gynecology, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie Paris; Inserm UMRS-938, Paris, France.

The aim of the present review, conducted according to PRISMA statement recommendations, was to evaluate the contribution of transvaginal sonography (TVS) and magnetic resonance imaging (MRI) to diagnose adenomyosis. Although there is a lack of consensus on adenomyosis classification, three subtypes are described, internal, external adenomyosis, and adenomyomas. Using TVS, whatever the subtype, pooled sensitivities, pooled specificities, and pooled positive likelihood ratios are 0. Read More

Fertil Steril 2018 03;109(3):380-388.e1

Leuven Institute for Fertility & Embryology, Leuven, Belgium; Life Expert Centre, Schipvaartstraat 4, Leuven, Belgium.

Where histology used the presence of glands and/or stroma in the myometrium as pathognomonic for adenomyosis, imaging uses the appearance of the myometrium, the presence of striations, related to the presence of endometrial tissue within the myometrium, the presence of intramyometrial cystic structures and the size and asymmetry of the uterus to identify adenomyosis. Preliminary reports show a good correlation between the features detected by imaging and the histological findings. Symptoms associated with adenomyosis are abnormal uterine bleeding, pelvic pain (dysmenorrhea, chronic pelvic pain, dyspareunia), and impaired reproduction. Read More

Gynecol Obstet Fertil Senol 2018 Mar 12;46(3):185-199. Epub 2018 Mar 12.

Service de Gynécologie-Obstétrique, CHU Lyon Croix-Rousse, Hospices Civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex, France; Université Claude-Bernard - Lyon 1, 69000 Lyon, France.

Endometriosis is difficult to diagnose clinically. Transvaginal sonography (TVS) is a procedure that is known to be operator-dependent, which mean that published evidences has to be balanced with the level of the sonographer that produced the data. The objective of this publication was to assess the performances of the sonography in the diagnosis of endometriosis in order to establish the French national recommendations. Read More

Gynecol Obstet Fertil Senol 2018 Mar 11;46(3):156-167. Epub 2018 Mar 11.

Service de chirurgie gynécologie obstétrique 2 et médecine de la reproduction, CHU Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Équipe génomique, épigénétique et physiopathologie de la reproduction, Inserm U1016, département développement, reproduction, cancer, université Paris Descartes, Sorbonne Paris cité, 12, rue de l'École-de-médecine, 75270 Paris cedex 06, France.

Endometriosis and adenomyosis are histologically defined. The frequency of endometriosis cannot be precisely estimated in the general population. Endometriosis is considered a disease when it causes pain and/or infertility. Read More

Fertil Steril 2018 03 8;109(3):369-370. Epub 2018 Mar 8.

Pôle de Gynécologie Institut de Recherche Expérimentale et Clinique (IREC), Université Catholique de Louvain, Brussels, Belgium; Gynecology Department, Cliniques Universitaires Saint Luc, Brussels, Belgium.

Like endometriosis, uterine adenomyosis is another enigmatic disease and remains a source of controversy. Uterine adenomyosis is characterized by the presence of endometrial glands in the myometrium. Two main theories may explain its pathogenesis: adenomyosis may arise from invagination of the myometrial basalis into the myometrium; or an alternative theory maintains that it may result from metaplasia of displaced embryonic pluripotent müllerian remants or differentiation of adult stem cells. Read More

J Zoo Wildl Med 2018 Mar;49(1):210-213

Uterine lesions in two orangutans were effectively managed with surgical intervention. A 26-year-old hybrid orangutan ( Pongo spp.) was diagnosed with uterine adenomyosis based on advanced imaging. Read More

J Obstet Gynaecol Res 2018 Jun 8;44(6):1169-1173. Epub 2018 Mar 8.

Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke-shi, Japan.

Degeneration of adenomyosis during pregnancy and the post-partum period is very rare. A 42-year-old Japanese parous woman with four normal-term deliveries, who presented with abdominal pain and fever at 22 weeks of gestation with transient increases of the white blood cell count and C-reactive protein, demonstrated sustained inflammation after cesarean section at 29 weeks of gestation due to the occurrence of gestational hypertension with late deceleration. The noncontrast-enhanced magnetic resonance imaging (MRI) at 22 weeks demonstrated a poorly demarcated hypointense area at the posterior uterine wall on T1- and T2-weighted imaging. Read More

Hum Reprod 2018 04;33(4):600-606

Institute for Women's Health, University College Hospital, 250 Euston Road, London NW1 6BU, UK.

Study Question: What would be a potential impact of implementing the new ESHRE/European Society of Gynaecological Endoscopy (ESGE) female genital anomalies classification system on the management of women with previous diagnosis of arcuate uteri based on the modified American Society for Reproductive Medicine (ASRM) criteria?

Summary Answer: A significant number of women with previous diagnosis of arcuate uteri are reclassified as having partial septate uteri according to the new ESHRE/ESGE classification system which may increase the number of remedial surgical procedures.

What Is Known Already: The ESHRE/ESGE classification system has defined measurement techniques, reference points and specific cut-offs to facilitate the differentiation between normal and septate uteri. These criteria have been arbitrarily defined and they rely on the measurement of uterine wall thickness and depth of distortion of uterine fundus. Read More

Best Pract Res Clin Obstet Gynaecol 2018 Aug 14;51:16-24. Epub 2018 Feb 14.

Department of Obstetrics and Gynecology, University Hospital K.U. Leuven, Herestraat 49, 3000, Leuven, Belgium. Electronic address:

Transvaginal ultrasonography has become the primary test in the diagnosis of pelvic endometriosis and adenomyosis. A review of the literature on the diagnostic accuracy of ultrasonography in pelvic endometriosis and adenomyosis, as well as a comparison with magnetic resonance imaging, will be presented. Criteria for diagnosis of an endometrioma according to robust prospective data together with guidelines as to adequate reporting of the location of deep infiltrating endometriosis will be given. Read More

J Magn Reson Imaging 2018 10 5;48(4):1024-1033. Epub 2018 Mar 5.

Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.

Background: The diffusion-weighted imaging (DWI) signals of the female pelvic bone marrow show great variability and are usually high in female patients with fibroid-associated symptoms and anemia.

Purpose: To ascertain clinical factors contributing to high signal intensity in the bone marrow of the female pelvis on DWI.

Study Type: Retrospective case-control study. Read More