ISSN: 2148-8274 / E-ISSN: 2587-0084
, Türk Üreme Tıbbı ve Cerrahisi
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Turkish Journal of Reproductive Medicine and Surgery

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Adenomyozis; Tanı, Klinik Bulgular ve Tedavinin Güncel Yaklaşımları
Adenomyosis; Diagnosis, Clinical Findings and Current Approaches to Treatment
Received Date : 13 Dec 2021
Accepted Date : 07 Apr 2022
Available Online : 05 Aug 2022
Özet PDF Benzer Makaleler
Begüm ERTANa, Aslı AKDÖNERa, Onur YAVUZa, Ezgi BİLİCENa, Erkan ÇAĞLIYANa
aDokuz Eylül Üniversitesi Tıp Fakültesi, Kadın Hastalıkları ve Doğum ABD, İzmir, Türkiye
Doi: 10.24074/tjrms.2021-87530 - Makale Dili: TR
TJRMS. 2022;6(1):135-41
ÖZET
Adenomyozis, endometriyal bez ve/veya stromanın hiperplastik ve hipertrofik myometriyum içinde bulunmasıdır. Histopatolojik olarak, diffüz ve fokal(adenomyoma) olmak üzere iki ana tipi vardır. Patogenezde junctional zonun anahtar rol oynadığı düşünülmektedir. Risk faktörleri net olmamakla birlikte perimenopozal ve multiparöz kadınlarda daha sık saptanmaktadır. Adenomyozisli hastaların 1/3’ü asemptomatiktir, geriye kalan hastalarda en sık görülen semptomlar ağır menstrüel kanama ve dismenoredir. Tanıda ilk tercih transvajinal ultrasonografidir. Şüphelenilen veya diğer benign uterin patolojilerle arada kalınan vakalarda manyetik rezonans görüntüleme tercih edilebilir. Tedavide ilk sorulacak soru gelecekteki fertilite arzusudur. Fertilitesini tamamlamış kadınlarda histerektomi küratif tedavi yöntemidir. Ayrıca hastalığın kesin tanısı da histolojik spesimen incelemesi ile konulmaktadır. Fertilite arzusu olan kadınlarda uterus koruyucu rezeksiyon tercih edilebilir. Bunun dışında medikal tedavi, endometrial ablasyon ve uterin arter embolizasyonu da tercih edilebilir.
Anahtar Kelimeler: Adenomyozis; ultrasonografi; manyetik rezonans görüntüleme; leiyomyoma
ABSTRACT
Adenomyosis is the presence of endometrial gland and/or stroma within the hyperplastic and hypertrophic myometrium. Histopathologically, there are two main types as diffuse and focal (adenomyoma). The junctional zone is thought to play a key role in the pathogenesis. Although the risk factors are not clear, they are more common in perimenopausal and multiparous women. 1/3 of patients with adenomyosis are asymptomatic, the most common symptoms in the remaining patients are heavy menstrual bleeding and dysmenorrhea. The first choice for diagnosis is transvaginal ultrasonography. Magnetic resonance imaging may be preferred in suspected cases or other benign uterine pathologies. The first question in the treatment is the desire for future fertility. Hysterectomy is a curative treatment method in women who have completed their fertility. In addition, the definitive diagnosis of the disease is made by histological specimen examination. Uterine-sparing resection may be preferred in women with a desire for fertility. Apart from this, medical treatment, endometrial ablation and uterine artery embolization may also be preferred.
Keywords: Adenomyosis; ultrasonography; magnetic resonance imaging; leiomyoma
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