The etiology differs regards to the locations of the lesion: a clinical experience of 1350 patients with adenomyosis confirmed by postoperative pathology

By stratifying adenomyosis into diffuse/focal and anterior/posterior subtypes, we identified distinct clinical-pathological profiles: (1) Diffuse adenomyosis was independently associated with older age, higher gravidity, and severe dysmenorrhea, suggesting a progressive phenotype driven by tissue injury mechanisms; (2) Posterior lesions exhibited a 3.24-fold risk of concurrent endometriosis and increased surgical complexity, implicating shared pathways with deep infiltrating endometriosis. These findings redefine adenomyosis as a heterogeneous disorder with subtype-specific pathophysiology, advocating for tailored therapeutic strategies.