Many pathologists define adenomyosis as the presence of endometrial glands and stroma in the myometrium more than 2-3 mm below the endomyometrial junction. The pathologic diagnosis of adenomyosis is highly dependent on the number of sections from the uterine specimen that are processed for analysis. Recent studies suggest that the Diagnosis A major problem with adenomyosis is that the diagnosis can be difficult to make before hysterectomy. As noted above, even after a hysterectomy is performed, the diagnosis of adenomyosis is dependent on the number of myo-metrial sections submitted for analysis. Numerous imaging tests have been used to help in the diagnosis of adenomyosis.
Transvaginal sonography has only modest sensitivity and specificity.
In a Treatment Hysterectomy is the only treatment that clearly is effective in the treatment of adenomyosis. Preliminary studies suggest that hormonal treatments effective in the treatment of myomata also can be used to successfully treat adenomyosis. In a small number of case reports, women with longstanding infertility and adenomyosis were treated successfully with Many women with infertility and severe adenomyosis have distortion and partial or complete occlusion of the intramural portion of the Treatment with a GnRH agonist reduces estradiol production and shrinks the adenomyosis lesions, which can result in tubal patency.