The etiology differs regards to the locations of the lesion: a clinical experience of 1350 patients with adenomyosis confirmed by postoperative pathology

作者：Wanqing Li, Y U C Hiao C Hang, Yunyu Xu, Wen Zhang, Ye He, Wei Ye, Xinyue Hu, Zhaolian Wei · 发表于：BMC Women s Health · 年份：2025 · DOI：10.1186/s12905-025-03759-3 · 被引用次数：2 · 研究领域：Endometriosis Research and Treatment、Reproductive tract infections research、Pelvic floor disorders treatments

BACKGROUND: Despite proposed mechanisms hypotheses, the etiology of adenomyosis remains unclear. The limited efficacy of current therapeutic approaches may stem from insufficient understanding of its pathobiological underpinnings and the pronounced heterogeneity in clinical presentation and treatment responsiveness among subtypes. This study seeks to compare clinical and sonographic profiles of adenomyosis subtypes to elucidate distinct disease mechanisms and inform subtype-specific management strategies. METHODS: In this retrospective cohort of 1,350 surgically treated and pathologically confirmed adenomyosis cases (2017-2022), patients were categorized into diffuse versus focal and anterior versus posterior lesion groups according to sonographic features. Comparative analyses of demographics, symptomatology, concurrent gynecological conditions, and laboratory profiles were conducted to delineate subtype-specific patterns. RESULTS: 1074 (79.56%) had a definitive adenomyotic sonographic signs, with 329 (30.63%) focal adenomyosis and 745 (69.37%) diffuse adenomyosis. Multivariate logistic regression analysis revealed that, compared with focal adenomyosis, diffuse adenomyosis were older (OR, 1.09; 95%CI: 1.06-1.12), had more pregnancies (OR, 1.22; 95%CI: 1.11-1.33), higher BMI (OR, 1.05; 95%CI: 1.00-1.09), long course of disease (OR, 1.06; 95%CI: 1.02-1.11) and higher risk of moderate to severe dysmenorrhea (OR, 1.88; 95%CI: 1.36-2.60). Divided to the location of adenomyosis le...