Histopathological Study of Adenomyosis and Leiomyomas in Hysterectomy Specimens in Patients of Abnormal Uterine Bleeding At Tertiary Care Centre

Abstract

BACKGROUND: Adenomyosis is a benign disorder of uterus in which glands and stroma of endometrium are pathologically present in the myometrium. Women having adenomyosis may present with AUB, dysmenorrhea, dyspareunia or infertility. Fibroid or leiomyoma is the most common tumour in women. Approximately more than 70% of women will have experienced at least one fibroid by the age of 50 years. Fibroids can cause miscarriage, preterm labour, obstruction of labour and subfertility.1Additionally, they may exert pressure on urinary system and cause discomfort.

AIM AND OBJECTIVES: 1. To study histopathological changes of adenomyosis and leiomyomas in hysterectomy specimens in patients of abnormal uterine bleeding at tertiary care centre. 2. To determine percentage of adenomyosis and leiomyomas in hysterectomy specimens.3. To study coexistence of adenomyosis and leiomyomas in hysterectomy specimens.

METHODS: Study Design: Descriptive Cross-sectional study. Study Population: Female patients admitted in Dr. PDMMC, hospital and research center, Amravati and undergone hysterectomy for abnormal uterine bleeding during study period such cases were included in the study. Study Duration: 18 months (2023 to 2025). Sample size: 349

RESULTS: The highest proportion (n=256, 73.35%) was observed in the 41–60 years age group, followed by 74 participants (21.20%) in the 21–40 years. pain in abdomen(P) was a presenting complaint in 299 (85.7%), menorrhagia was a presenting complaint in 298 (85.4%) and Dysmenorrhea(D)was a presenting complaint in 224 (64.2%) participants. Out of 349 participants, 232 (66.5%) had leiomyoma, out of which intramural leiomyoma was the most common type (n = 196, 84.5%) followed by intramural subserosal combination (n = 15, 4.3%). Out of 349 participants, 97 (28%) had adenomyosis on, Age group of 41-60 years had the largest number of adenomyosis cases. Out of these 349, majority specimens showed proliferative phase (n = 175, 50.14%) followed by secretary phase (n = 138, 39.4%). Out of 349 participants, 154 (44.1%) had hyperplasia, 19 (5.4%) had hyperplasia with or without atypia and 24 (6.9%) had endometrial polyp. Out of 349 participants, 64 (18.3%) had coexistence of leiomyoma and adenomyosis of myometrium.

CONCLUSIONS: The highest proportion was observed in the 41–60 years age group, Most common complaint was pain in abdomen, 66.5% had leiomyoma, out of which intramural leiomyoma was the most common type, 28% had adenomyosis, majority specimens showed proliferative phase,18.3% had coexistence of leiomyoma and adenomyosis of myometrium.