Adenomyosis is defined as the heterotopic presence of endometrial mucosa (glands and stroma) abnormally implanted within myometrium with a range of clinical presentations, the most common being heavy menstrual bleeding and dysmenorrhoea; nevertheless, patients can also be asymptomatic. This review describes the state of the art of role of hysteroscopy and laparoscopy in the diagnosis of adenomyosis according to recent literature findings. Hysteroscopy offers the advantage of direct visualization of the uterine cavity, and nowadays is performed in the office. It is immediately preceded by a physical exam and a transvaginal ultrasound (TVUS) to evaluate uterine characteristics. It is offers the possibility of obtaining endometrial/myometrial biopsies under visual control. Laparoscopy is not traditionally considered a diagnostic tool for adenomyosis, but it can have a complementary role in the differential diagnosis of this insidious pathology.
Cite this article
Differential diagnosis of adenomyosis: the role of hysteroscopy and laparoscopy
1 U.O.C. Obstetrics and Gynecology, Ospedale San Francesco, Nuoro, Italy
2 Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, Foggia, Italy
3 Department of Surgical Sciences, Institute of Obstetrics and Gynecology, University of Cagliari, Cagliari, Italy
Clin. Exp. Obstet. Gynecol. 2019 , 46(4), 511–515; https://doi.org/10.12891/ceog4814.2019
Published: 10 August 2019