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adenomyosis
• Retrograde menstruation
• Vascular dessimination
• Metaplasia
• Genetic disposition
• Typical patient in her mid 30's is
nulliparous, and involuntarily infertile
• Transplanted
• After cs
• Episiotomy
Immunologic
changes
• More peritoneal macrophages that are
larger
• Pelvic peritoneum over the uterus, anterior and posteriorcul de sac and
uterosacral, round and broad ligament
• They are red, brown, black white and yellow, pink clear or red vesicle
• The predominant color depends on the blood supply and the amount of
hemorrhage and fibrosis
• Size is also related to the size of lesion, degree of edema and amount of
inspissated material
• New lesions are small, bleblike implants
that are less than 1cm in diameter
• Ovaries may be enlarged and tender and are often fixed to the
broad ligament or lateral pelvic sidewalls
• Ultrasound examination
• 6-9 mths
Gonadotropin releasing
hormones agonist
• Leuprolide3.75mg im once per mth or an
11.25mg every three months
• 6-12 months
• Levonorgestrel IUS
Adenomyosis
• 35-50 yo