Understanding clinical features of adenomyosis: a case control study.

Adenomyosis is largely under diagnosed before hysterectomy and commonly co-exists with uterine fibroid. Thus this study aimed to elicit the clinical profile of adenomyosis by comparison with uterine fibroid. This is a hospital based prospective case-control study carried out from 1st April 2010 to 31st May 2011 which comprise of women undergoing hysterectomy with a histological diagnosis of sole adenomyosis without fibroid, women with both adenomyosis and fibroid and women with fibroid but no adenomyosis. Ambulatory records were performed. The study comprised 150 women, 78 (52%) women with adenomyosis without fibroid, 27 (18%) women with both adenomyosis and fibroid, 45 (30%) women with fibroid but no adenomyosis. Among women with adenomyosis alone, 78.2% had menorrhagia, 73.1% had dysmenorrhoea, 76.9% had chronic pelvic pain and women with adenomyosis and fibroid had menorrhagia in 85.2%, dysmenorrhoea in 51.9%, chronic pelvic pain in 48.1% compared with women of fibroid alone had menorrhagia in 75.6%, dysmenorrhoea in 66.77%, chronic pelvic pain in 51.1%. Women with adenomyosis group had significantly more of chronic pelvic pain (p-value: 0.003) and had significantly greater parity (p-value: 0.002). Size of uterus was significantly smaller in adenomyosis group (p-value: 0.018) as well as significantly more tender uterus was found in adenomyosis group (p-value: 0.000). Adenomyosis is more frequent among women reporting dysmenorrhoea, menometrorrhagia, chronic pelvic pain and along with bulky uterus. Women with fibroid alone has more of menorrhagia than pain and is associated with enlarge uterus. If women have small fibroid uterus but have more symptoms--think about co-existence of "ADENOMYOSIS".