WOMENS-HEALTH Messages for January, 2001: Re: for OBGYN. How to diagnose adenomyosis?

Re: for OBGYN. How to diagnose adenomyosis?

From: William McIntosh, MD (anonymous@obgyn.net)
Wed, 24 Jan 2001 10:43:40 -0600 (CST)

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At Tue, 23 Jan 2001, anonymous@obgyn.net wrote: >
>This is for any doctor who can help me.
>
>I was "diagnosed" with adenomyosis as well as swollen blood vessels in
>pelvis and adhesions in september 2000 after having a laparoscopy. I
>was under the impression from my doctor and others that a "diagnoses"
>could be made with a laporoscopy. However, after reading here on the
>forum:
>
>"Adenomyosis is a pathologic/microscopic diagnosis made on the surgical
>specimen FOLLOWING hysterectomy"
>
>I am very confused.I was told that having a hystterectomy would "cure"
>the pain that I am in. But, if my doctor can not know for sure that
>what I am experiancing is due to Adenomyosis until after hyst. how then
>can he/she say a hyst. should be considered?
>
>SOME BACKGROUND
>I started my menses at age 11 and have had pain and heavy bleeding ever
>since. I was put on the pill at age 13 because of the irregularity of
>my periods and the severe cramping (hardly helped). I have tried to
>just "live with it" because I thought it was "normal". Not until about
>four years ago did I hear of Endometriosis and scheduled a lap. before
>I was to be put under they did a pregnancy test and I was pregnant so we
>postponed the surgery. I have two children and lost a child at 22weeks.
>My youngest is 2+ and was delivered by C-Section. I have read that all
>these factors can contribute to Adenomyosis.
>
>If anyone can clear this up I would be so grateful. I am only 32 years
>old and do not want to undergo a hyst. if it is not necessary. Also
>could somone give the pronunciation of Adenomyosis I feel so silly not
>knowing how to say it.
>
>Thank you in advance and I am sorry this is so long.

Adenomyosis can be suspected from history and the gross appearance of the uterus on laparoscopy, but it can only be diagnosed by having all or a portion of the uterus in the pathology lab. Your history is consistent with adeno, and your doctor feels the appearance is also consistent with that diagnosis. There is an element of doubt, but it is down to an irreducible minimum. In the end, you will have to make your best guess, take a deep breath, and take the plunge, either for or against Hyst.

-- William D. McIntosh, MD, FACOG

This is for educational purposes only, and is not a substitute for consultation and examination by a licensed medical professional.

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