CLINICODIAGNOSTIC PARALLELS IN ADENOMYOSIS-RELATED INFERTILITY
https://doi.org/10.25207/1608-6228-2017-24-4-65-73
Abstract
Aim. The aim of this study was to determine parallel between clinical manifestations of adenomyosis and imaging methods data.
Materials and methods. 247 patients were examined, from which is formed clinical groups: 1st group included 26 patients (35,1%), and 2nd group – 23 patients (31,1%) with adenomyosis-related infertility, 3rd group (control) – 25 patients (33,8%). It has been clarified reproductive anamnesis, estimated clinical course of adenomyosis and performed hysteroscopy, and ultrasound assessment of resistance indexes in uterus vessels, Hatle index, thickness of «transition area» on MRI.
Results. The intensity of algomenorrhea, dyspareunia, and pelvic pain outside of menses is correlated with US data: the resistance indexes (RI) of uterus vessels as Hatle index and thickness of «transition area» were significantly higher in groups 1 and 2 than in control (р<0,0001); hypervascularization and the presence of the dark red areas showed high sensitivity and specificity; the correlation coefficient between hysteroscopically signs and visual evaluation scale of pain came to R=0,637.
Conclusion. The severity of the adenomyosis clinical intensity is correlated with US, MRI, and hysteroscopy data.
About the Authors
A. R. Jhigalenko
Kuban State Medical University of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Department of General Surgery
350063, Krasnodar, 4 Sedina Street.; tel.: +7-988-244-40-44
l. Yu. Karakhalis
Kuban State Medical University of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Department of General Surgery
Corresponding author: Lyudmila Y. Karakhalis
350063, Krasnodar, 4 Sedina Street.; tel.: +7-988-244-40-44
N. S. Papova
Kuban State Medical University of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Department of General Surgery
350063, Krasnodar, 4 Sedina Street.; tel.: +7-988-244-40-44References
1. Adamyan L.V., Kulakov V.I., Andreeva E.N. – Endometriosy. – M.: Meditsina, 2006. – 416. (in Russ).
2. Baskakov V.P., Tsvelev, Yu.V., Kira, E.F. Endometrioidnaya Bolezn'. – SPb.: Izdatel'stvo N–L., 2002. – 452.
3. Damirov N.N. Adenomioz. – M.: Binom, 2004.-384.
4. Strijhakov A.N., Davydov A.I., Pashkov V.M. Adenomioz: vozmojhnosti i perspectivy endohirurgicheskogo lecheniya s uchetom morfologicheskogo stroenia miometria, endometria i yaichnikov // Jhurnal akuscherstva b jhenskih boleznei. – 2002. – LI, №3. – S. 28-31. ( in Russ)
5. Adenomyosis: US features with histologic correlation in an in vitro study / Atri M. [et al.] // Radioligy. – 2000. – Vol. 215. – P. 783790.
6. Amor R. Endometriosis. Symptoms and diagnosis. // J.Gynecol. Obstet. Mex. – 2001. – Vol. 69. – P. 288-296.
7. Benson RC, Sneeden VD. Adenomyosis: a reappraisal of symptomatology. Am J Obstet Gynecol. 1958; 76: 1044-1057.
8. Laparoscopic excision of myometrial adenomyomas in patients with adenomyosis uteri and main symptoms of severe dysmenorrheal and hypermenorrhea / Moriuta M. [et al.] // J.Am.Assoc. Gynecol. Laparosc. – 2004. – Vol.17. – P.86-95.
9. Menorrhagia and adenomyosis in a patient with hyperhomocysteinemia, recurrent pelvic vein thrombosis and extensive uterine collateral circulation treatment by supracervical hysterectomy/ Nawroth F, [et al.] // Eur.Obstet.Gynecol.Reprod.Biol. – 2001. – Vol.98. – P. 240-243.
10. Bird CC, McElin TW, Manalo-Estrella P The elusive adenomyosis of the uterus-revisited. Am J Obstet Gynecol. 1972; 112: 583-593.
11. Lee NC, Dicker RC, Rubin GL, Ory HW. Confirmation of the preoperative diagnoses for hysterectomy. Am J Obstet Gynecol. 1984; 150: 283-287.
12. Barrier BF, Malinowski MJ, Dick EJ Jr, Hubbard GB, Bates GW. Adenomyosis in the baboon is associated with primary infertility. Fertil and Steril. 2004; 82: 1091-1094.
13. Healy D.L., Breheny S., Halliday J. et al. Prevalence and risk factors for obstetric haemorrhage in 6730 singleton births after assisted reproductive technology in Victoria Australia // Hum. Reprod. 2010. Vol. 25. № 1. P. 265-274.
14. Juang C.M., Chou P., Yen M.S. et al. Adenomyosis and risk of preterm delivery // BJOG. 2007. Vol. 114. № 2. P. 165-169.
15. Yeung P, Gupta S, Gieg S. Endometriosis in adolescents: a systematic review. J Endometr Pelvic Pain Disord. 2017. Doi: 10.5301/je.5000264 [ Links ]
16. Halafyan, A.A. Statistica 6. Matematicheskaya statistika s elementami teorii veroyatnostei. Uchebnik. M.:BINOM. – 2010. – 496.
17. Karahalis, L.Yu., Penjhoyan G.A., Chervonnaya J.Yu., Vasina J.B. Obosnovanie vybora preparatov pri adenomiose dlya vosstanovleniya reproductivnogo potenziala // Vrach. – 2010. – № 10. – P.57-62
18. Savel'eva G.M., Breusenko V.G., Kappuscheva L.M. Gisteroskopiya: atlas i rukovodstvo. – M.: GEOTAR-Media, 2013. – 248.
Review
For citations:
Jhigalenko A.R., Karakhalis l.Yu., Papova N.S. CLINICODIAGNOSTIC PARALLELS IN ADENOMYOSIS-RELATED INFERTILITY. Kuban Scientific Medical Bulletin. 2017;(4):65-73. (In Russ.) https://doi.org/10.25207/1608-6228-2017-24-4-65-73
Views:
451
Email this article 