Characteristics associated with postoperative diagnosis of adenomyosis or combined adenomyosis with fibroids

Objective To identify clinical characteristics associated with combined adenomyosis and fibroids and to determine whether preoperative diagnosis by ultrasonography correlates with postoperative diagnosis by pathology. Methods A retrospective chart review was conducted of 206 women who attended Nassau University Medical Center, East Meadow, USA, between July 1, 2007, and June 30, 2010. The patients were stratified into 3 groups - fibroids only (n = 148); adenomyosis only (n = 21); or combined adenomyosis and fibroids (n = 37) - according to postoperative pathology findings and variables known to be associated with adenomyosis and fibroids. Significant variables were included in a multinomial regression analysis. Results Dysmenorrhea was the only variable significantly associated with a diagnosis of adenomyosis. The odds ratio (OR) was 3.34 (95% confidence interval [CI], 1.14-9.80). Variables significantly associated with combined adenomyosis and fibroids were age (OR, 1.08; 95% CI, 1.01-1.15), black ethnicity (OR, 2.72; 95% CI, 1.11-6.68), and parity (OR, 1.44; 95% CI, 1.08-1.92). Preoperative diagnosis by ultrasonography did not correlate with the postoperative pathology report. Conclusion Including the identified variables in the preoperative evaluation of patients with suspicion of fibroids might improve the counseling process and aid the choice of surgical procedure, especially among patients desiring a conservative approach.