Ricerc@Sapienza

Adenomyosis is a common gynecological disorder, affecting about 45% of women in reproductive age. It is defined as the presence of endometrial glands and stroma within the myometrium associated with myometrial hypertrophy and hyperplasia. The cause of adenomyosis is unknown, but interesting theories have considered adenomyosis a pathology of the endo-myometrial junctional zone. Clinical presentation of adenomyosis could be heterogeneous. It can be asymptomatic in about 35% of patients. Typical presentation of disease (70% of women) includes abnormal uterine bleeding (AUB), and pelvic painful symptoms. The definitive diagnosis is usually based on histological examination in surgical specimens. However transvaginal ultrasound (TV-US) and MRI are widely accepted as valid instrument to reach a presurgical diagnosis. Several studies showed that the sensitivity and specificity of two-dimensional transvaginal scan in diagnosing adenomyosis are comparable to those of MRI, histology, or both, ranging from 75%¿88% and 67%¿93%, respectively. Although several tentative of defining criteria for a universally accepted diagnosis of adenomyosis were proposed, nowadays is still not well defined a score of the severity of adenomyosis. This prospective observational study aims to identify a score derived by a combination of clinical, imaging features correlated to pathology. There would be 2 major sections, both subdivided. All subdivisions would be given a total score of 3, ranging from 1 and the final addition would determine an overall classification into 4 main groups based on severity. This score will address the physicians to the best therapeutic approach.
A better understanding of the relationship between adenomyosis and pain can help improve counseling of women regarding the signi¿cance of this common condition and make treatment options more focused. The adenomyosis should be standardized according to universally accepted criteria in terms of disease severity.