Evaluation of the relationship between prior uterine surgery and the incidence of adenomyosis in the Shariati Hospital in Bandar-Abbas, Iran, from 2001 to 2011

BACKGROUND Adenomyosis is a common benign disorder in pre-menopausal women that presents with uterine enlargement, pelvic pain, heavy menstrual bleeding, and dysmenorrhea. However, its risk factors have not been clearly determined. The aim of this study was to determine whether prior uterine surgery is a risk factor for adenomyosis. METHODS In this cross-sectional study, we reviewed the medical records of all women who had hysterectomies for benign and a non-emergency, gynecological condition during 2001-2011 at Shariati Hospital in Bandar-Abbas, Iran. The variables in the study included age, gravidity, parity, abortion, prior uterine surgery, and the size of the uterus before hysterectomy. The data were analyzed by Microsoft Excel and SPSS version 16, by conducting descriptive statistics, by the t-test, and by Analysis of Variance (ANOVA). RESULTS Of the 191 participants, 72 women (37.7%) had pathologically-confirmed adenomyosis. Women with adenomyosis reported a history of prior uterine surgery more frequently than women without adenomyosis (P = 0.01), but age, menarche, gravidity, parity, and history of abortion were similar between the two groups (P > 0.05). CONCLUSION History of prior uterine surgery is a risk factor for adenomyosis.