КОМОРБІДНІСТЬ АДЕНОМІОЗУ ТА ХРОНІЧНОГО ЕНДОМЕТРИТУ: СУЧАСНИЙ СТАН ПРОБЛЕМИ ТА ВЛАСНІ РЕЗУЛЬТАТИ

Current concepts regard adenomyosis as a dynamic process in which the junction zone plays a central pathogenetic role, particularly when adenomyosis is combined with chronic endometritis. Analysis of international sources and our retrospective study (n = 276) highlights the characteristics the co-occurrence of these conditions Aim of the study. To analyse the comorbidity of adenomyosis and chronic endometritis and to determine the detection frequency and specific clinical and anamnestic profile of this combined condition through retrospective analysis of clinical data Materials and methods. A comprehensive review of the literature from 2019 to 2026 focused on the pathogenesis and characteristics of the concomitant course of adenomyosis and chronic endometritis at the junction zone level. The clinical component comprised a retrospective study of 276 female patients with chronic endometritis. Statistical analysis was performed using STATISTICA 8.0 software. The study was approved by the Bioethics Committee of I. Horbachevsky Ternopil National Medical University of the Ministry of Health of Ukraine (Protocol No. 85, April 1, 2026) and conducted as part of an interdepartmental research project between the Department of Obstetrics and Gynecology No. 2 and the Department of Pathological Anatomy, Autopsy Course and Forensic Medicine at I. Horbachevsky Ternopil National Medical University of the Ministry of Health of Ukraine, entitled ‘Clinical and morphological aspects of endometrial diseases. The application of new information technologies for their early diagnosis, treatment and prevention’ (state registration number 0124U000802, 2023–2026). Results. Literature review revealed no unified pathogenetic understanding of adenomyosis (A) development or the role of the junction zone (JZ) in comorbidity with chronic endometritis (CE). Among the 276 cases, isolated CE was found in 38.04% of patients, combination with A alone in 2.17%, and combination with two or more conditions in 59.79%. Conclusions. 1. The high comorbidity rate associated with chronic endometritis (59.79%) indicates its role as a trigger for structural and functional uterine changes and as a predictor of various nosological conditions. 2. The isolated course of chronic endometritis in 38.04% of patients suggests a prolonged latent period of hidden destructive changes before the manifestation of concomitant pathology. 3. The low frequency of chronic endometritis occurring concurrently with adenomyosis is associated with technical difficulties in diagnostic verification and the predominantly asymptomatic course of the condition in its early stages.