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Adenomyosis uteri: an update

^1. Reproductive Sciences Section — Department of Cancer Studies and Molecular Medicine, University of Leicester, Leicester LE2 7LX, UK Email: mkm7{at}le.ac.uk (corresponding author)
^2. Reproductive Sciences Section — Department of Cancer Studies and Molecular Medicine, University of Leicester, UK

Key content:

• Adenomyosis uteri is defined by the presence of endometrium in the myometrium.
  
• The prevalence in asymptomatic women remains unknown.
  
• It is commonly associated with other pathologies.
  
• Hysterectomy remains the main surgical option for women whose families are complete.
  

Learning objectives:

• To understand the theories regarding the aetiology.
  
• To appreciate the clinical picture and complications.
  
• To learn about current treatment modalities.
  

Ethical issues:

• Counselling women with adenomyosis uteri is challenging when the clinical significance of the condition is uncertain.
  
• Are more expensive diagnostic tests, such as magnetic resonance imaging, justifiable?
  
• Is the risk–benefit weighted against invasive investigation?
  

Please cite this article as: Mehasseb MK and Habiba MA. Adenomyosis uteri: an update. The Obstetrician & Gynaecologist 2009;11:41–47.

Keywords endometrial–myometrial interface / endomyometrial ablation / hysterectomy / magnetic resonance imaging (MRI)