†These authors contributed equally.
Academic Editor: Michael H. Dahan
Background: Uterine adenomyosis is defined as the presence of ectopic
endometrial tissue in the myometrium of the uterus and is a known cause of
chronic pelvic pain, heavy menstrual bleeding, and subfertility. However, its
pathogenesis is not completely established. Several reports have suggested that
vascular endothelial cell growth factor (VEGF) may be associated with the
progression of adenomyosis. The goal of this study was to evaluate the role of
VEGF on pathophysiology of uterine adenomyosis by comparing expression of VEGF in
the same uterus and in the endometrium and myometrium, with patients’
adenomyosis. Methods: We analyzed 22 premenopausal patients with a focal
type of uterine adenomyosis who received an adenomyomectomy between December 2019
and April 2020 at our hospital. All patients were preoperatively treated with
gonadotropin-releasing hormone(GnRH) analogs. During these surgeries, samples
were obtained from the uterus of each patient which included the adenomyosis
lesion, the myometrium without adenomyosis, and endometrial tissue.
Immunohistochemistry stain of VEGF and real-time polymerase chain reaction
(RT-PCR) of VEGF expression were compared for each of three points in the uterus.
We also compared microvascular density in the adenomyosis lesion between the
ectopic endometrial gland and myometrial stroma. Results: VEGF
expression was found to be increased in adenomyotic lesions and myometrium
compared with the eutopic endometrium (p