Laparoscopic uterine biopsy for diagnosing diffuse adenomyosis

Paolo Vercellini, Laura Trespidi, Stefania Panazza, Tiziana Bramante, Fabio Mauro, Pier Giorgio Crosignani

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: To investigate the possibility of diagnosing diffuse adenomyosis with the uterus in situ. STUDY DESIGN: Myometrial needle biopsy was performed on a prospectively evaluated series of 72 women undergoing laparoscopy for infertility and/or chronic pelvic pain. Before surgery the patients completed a questionnaire on the presence and severity of dysmenorrhea according to a linear analog and verbal rating scale. A single specimen was taken from along the median line in the upper third of the posterior uterine wall using a 14-gauge Tru-cut needle inserted through the anterior abdominal wall under laparoscopic guidance. RESULTS: No complications occurred. Adenomyosis was diagnosed in 8 of the 42 subjects with menstrual pain and 5 of the 30 asymptomatic ones (19% versus 17%) and pelvic endometriosis in 27 and 10, respectively (64% versus 33%, P = .02). The frequency of moderate or severe dysmenorrhea was greater in women with adenomyosis than in those without adenomyosis or endometriosis, but the difference was not statistically significant. Conversely, menstrual pain was significantly more frequent and severe in patients with endometriosis as compared with women who had neither endometriosis nor adenomyosis. CONCLUSION: Uterine needle biopsy is simple, rapid and safe, but its overall clinical importance, as well as the predictive value of a normal histologic result, requires further investigation.

Original languageEnglish
Pages (from-to)220-224
Number of pages5
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume41
Issue number4
Publication statusPublished - 1996

Keywords

  • adenomyosis
  • endometriosis
  • laparoscopy
  • uterine diseases

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Reproductive Medicine

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