Prevalence of Adenomyosis in Hysterectomy Specimens from Patients with Benign Gynecological Conditions

Background: Adenomyosis is defined by the ectopic presence of endometrial tissue within the myometrium. The reported histopathological prevalence in hysterectomy specimens varies substantially (۸.۸–۶۱.۵%), and associated risk factors remain a subject of debate.Objectives: This study aimed to determine the prevalence of adenomyosis in hysterectomy specimens obtained for benign gynecological indications and to evaluate its association with key demographic and clinical variables.Methods: This cross-sectional investigation (۲۰۲۳–۲۰۲۵) consecutively enrolled ۹۹ women who underwent hysterectomy for benign conditions at hospitals affiliated with Mashhad Medical Sciences, Islamic Azad University. Patients with gynecological malignancies or incomplete medical records were excluded. Demographic and obstetric data, including age, body mass index (BMI), educational attainment, gravidity, parity, mode of delivery, and history of abortion, were systematically recorded. Adenomyosis was diagnosed through histopathological examination. Following assessment of normality using the Shapiro–Wilk test, continuous variables were compared using the independent-samples t-test, and categorical variables were analyzed using the chi-square test (statistical significance set at p < ۰.۰۵).Results: Adenomyosis was histologically confirmed in ۳۶ women (۳۶.۴%). The mean age of the cohort was ۵۵.۳ ± ۱۰.۴ years, and the mean BMI was ۲۷.۷ ± ۳.۷ kg/m². Women diagnosed with adenomyosis exhibited a significantly higher mean BMI compared to those without the condition (۳۰.۱ ± ۳.۰ vs. ۲۶.۳ ± ۳.۴ kg/m²; p < ۰.۰۰۱). In the categorical analysis, adenomyosis was absent in all participants with a normal BMI (<۲۵ kg/m²) but was identified in ۳۸.۳% of overweight women and ۵۸.۱% of obese women (p < ۰.۰۰۱). No statistically significant associations were observed between adenomyosis and age, gravidity, parity, mode of delivery, history of abortion, or educational level.Conclusion: Adenomyosis was present in over one-third of hysterectomy specimens obtained for benign indications. Elevated BMI emerged as the sole significant risk factor associated with the condition, highlighting overweight and obesity as potentially modifiable contributors to adenomyosis pathogenesis.

کلیدواژه ها:

Adenomyosis ، body mass index ، Hysterectomy ، Benign Gynecologic Diseases ، risk factors