The use of surgical hysteroscopy as an auxiliary method in the diagnosis of adenomyosis. Is it possible?
DOI:
https://doi.org/10.33448/rsd-v11i10.32369Keywords:
Adenomyosis; Hysteroscopy; Diagnosis.Abstract
Objective: To address the aspects surrounding the diagnosis of adenomyosis, especially relating the histological findings of biopsies obtained by surgical hysteroscopy with clinical data suggestive of this pathology. Methodology: This is a retrospective observational and cross-sectional study, carried out from the analysis of questionnaires and test results from patients submitted to hysteroscopic biopsy, in a private hospital in the city of Divinópolis-MG. Data analysis was performed, especially between clinical symptoms and confirmation or not of adenomyosis in the anatomopathological samples. Results: It was possible to observe that the most prevalent symptomatology was menorrhagia (76.1%) and menstrual cramps (69.2%), in addition to the fact that the best results of the association of positive hysteroscopic biopsy for adenomyosis with the symptomatology were obtained from the comparison with more than 3 symptoms presented by the patients, with better sensitivity (60.7%), specificity (57.5%) and accuracy (58.8%) and, in the comparison with 3 symptoms, there was the highest negative predictive value (85, 7%). Conclusion: The analysis of biopsy results by surgical hysteroscopy, together with the management of associated symptoms, did not present sufficiently high results for its consolidation as a diagnostic test of adenomyosis in this study. Even so, the scarcity of data in the current literature on this comparison indicates the need to investigate the existence of other possible directions in the still imprecise diagnosis of this pathology, when approached by less invasive methods than hysterectomy.
References
Afonso, M. C., Castro, C., Osório, F., Clode, N. & Jorge, C. C. (2014). Adenomyosis: na atypical presentation. Acta Obstet Ginecol Port, 8(3): 297-299.
Cheung, V. Y. T. (2017). Current status of high-intensity focus ed ultrasound for the management of uterine adenomyosis. Ultrasonography, 36(2): 95.
Dakhly, D., Moety, G., Saber, W., Allah, S., Hashem, A. & Salam, L. (2016). Accuracy of Hysteroscopic Endomyometrial Biopsy in Diagnosis of Adenomyosis. Journal Minimaly Invasive Gynecology, 23(3): 364-371.
DATASUS – Ministério da Saúde. População residente- estudo de estimativas populacionais por município, idade e sexo 2000-2015, Brasil. Retrieved 15 September 2019.
Donnez, J. & Dolmans, M. M. (2018). Introduction: Uterine adenomyosis, another enigmatic disease of our time. Fertility and sterility, 109(3): 369-370.
Ferraz, Z., Nogeira-Martins, N. & Nogeira-Martins, F. (2017). Adenomyosis: Back to the future? Facts, views & vision in Ob Gyn. 9(1): 15-20.
Levy, G., Dehaene, A., Laurent, N., Lernout, M., Collinet, P. & Lucot, J. P. (2013). An update on adenomyosis. Diagnostic and interventional imaging, 94 (1): 3-25.
Krentel, H., Cezar, C., Becker, S., Sardo, A., Tanos, V., Wallwiener, M. & De Wilde, R. l. (2017). From Clinical Symptoms to MR Imaging: Diagnostic Steps in Adenomyosis. Bio Med research international, 2017 (3): 1-6.
Harada, T., MonKhine, Y., Kaponis, A., Nikellis, T., Decavalas, G. & Taniguchi, F. (2016). The impact of adenomyosis on women's fertility. Obstetrical & gynecological survey, 71(9): 557-568.
Hong, S. C., &Khoo, C.K. (2016). An update on adenomyosis uteri. Gynecology and Minimally Invasive Therapy, 5(3): 106-108.
Li, J., Chung, J., Wang, S., Li, T. & Duan, H. (2018). The Investigation and Management of Adenomyosis in Women Who Wish to Improve or Preserve Fertility .Bio Med research international, 2018(1): 1-12.
Macedo, C. S. & Barreiro, M. (2017). Adenomiose e Saúde Reprodutiva. Acta Obstétrica e Ginecológica Portuguesa, 11(3): 198-207.
Naftalin, J., Hoo, W., Nunes, T., Hollan, D. & Mavrelos, D. (2016). Association between ultrasound features of adenomyosis and severity of menstrual pain. Ultrasound in Obstetrics & Gynecology, 47(6): 779-783.
Sardo, A., Calagna, G., Santangelo, F., Zizolfi, B., Tanos, V., Perino, A., & Leon De Wilde, R. (2017). The role of hysteroscopy in the diagnosis and treatment of adenomyosis. Bio Med research international, 2017(1):1-7.
Senturk, L. M. & Imamoglu, M. (2015). Adenomyosis: whatis new? Women's Health, 11(5): 717-724.
Taran, F.A., Stewart, E.A. & Brucke,r S. (2013). Adenomyosis: Epidemiology, Risk Factors, Clinical Phenotype and Surgical and Interventional Alternatives to Hysterectomy. Geburtshilfe Frauenheilkd, 73(9): 924-931.
Tsui, K., Lee, W., Chen, C., Sheu, B., Yen, M., Chang, T. & Wang, P. (2014). Medical treatment for adenomyosisand or adenomyoma. Taiwanese Journal of Obstetrics and Gynecology, 53(4): 459-465.
Vargas, A., Botogoski, S., Lima, S., Conte, A., Rossato, C., Karoleski, L. & Benites, M. (2013). Estudo comparativo entre histeroscopia e ultrassonografia como métodos diagnósticos de patologias intrauterinas. Arquivos Médicos dos Hospitais da Faculdade de Ciências Médicas da Santa Casa de São Paulo (58): 1-5.
Vieira, S (2019). Fundamentos de Estatística. (6a ed.) Editora Atlas.
Yen, C. F., Chou, H. H., Wu, H. M., Lee, C. L. & Chang, T. C. (2019). Effectiveness and appropriateness in the application of office hysteroscopy. Journal of the Formosan Medical Association, 118(11): 1480-1487.
Zhang, L., Rao, F., & Setzen, R. (2017). High intensity focus ed ultrasound for the treatment of adenomyosis: selection criteria, efficacy, safety and fertility. Acta Obstet Gynecol Scand, 96(6): 707-714.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Emanuela Oliveira; Edson Araújo Rios Júnior; Isabelle Gaede Borges de Medeiros ; João da Mata Albino Araújo ; Júlia Maria de Freitas Alves ; Rafaela Araújo Lisboa ; Paulo Macêdo de Oliveira Leite
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.