Clinicopathological Correlation of Adenomyosis with Literature Review – A Retrospective Audit

Background and Aim: Adenomyosis is a complex pathological entity that affects the uteri of women in their reproductive years. The aim of this retrospective study was to find the occurrence of adenomyosis in hysterectomized specimens of the uteruses and to correlate it to the severity of symptoms that these women suffered. Materials and Methods: We retrospectively searched the records of women who have undergone hysterectomies for various indications from April 2019 to April 2020. The records of women who have undergone hysterectomies for various indications in the year of the study were searched to understand the incidence of the condition and the nature of their clinical presentation. Results: Out of 146 cases in the study period, we had 41.78% of the patients having histopathological evidence of adenomyosis. Adenomyosis on histopathology was found in 7 out of 25 women operated for prolapse uterus, 12 out of 55 women operated for fibroid, and 3 out of 12 women operated for endometrial causes. Only 80% of the women with a preoperative diagnosis of adenomyosis showed the histopathological features of adenomyosis, and 20% had no evidence of the condition. Out of 146 specimens with histopathological elements of adenomyosis, only 21 women had a preoperative diagnosis of the condition. Conclusion: Most of the time, the definitive diagnosis of adenomyosis is retrospective by histopathological examination of hysterectomy specimens. The presence of adenomyosis – as seen on histopathological examination of the uteri – does not always match the clinical presentation.