PDF(Pubmed)
Abstract：
BACKGROUND: Thomas Cullen described bleeding abnormalities and dysmenorrhea as the \"expected\" presentations of adenomyomas. Adenomyosis is included within the FIGO classification of structural causes of abnormal uterine bleeding (AUB). Nevertheless, this long-standing association has been questioned by some authors who reported a high incidence of adenomyosis in uteri removed for indications other than AUB or dysmenorrhea. Here, we examine evidence for the link between adenomyosis and AUB.
METHODS: A comprehensive Medline literature review of all publications to October 2023.
RESULTS: Sixty-three articles were identified and included in the review. Despite a large body of studies, the available literature does not provide conclusive evidence of a link between adenomyosis and AUB. This is because of unsuitable study design, or poor characterization of the study population or of the inclusion or exclusion criteria. Additional challenges arise because of the lack of agreed criteria for diagnosing adenomyosis and the often absence of detailed assessment of menstrual blood loss. Adenomyosis often coexists with other conditions that have also been linked to similar symptoms, and many cases of adenomyosis are asymptomatic.
CONCLUSIONS: Most of the existing literature and studies that addressed treatment outcome of adenomyosis started from the premise that a link between the condition and AUB had been proven. Yet, published information shows that aspects such a relationship is still uncertain. Further research is needed to address the relation between AUB and adenomyosis burden (or subtypes), distribution, and concomitant pathology.
METHODS: A comprehensive Medline literature review of all publications to October 2023.
RESULTS: Sixty-three articles were identified and included in the review. Despite a large body of studies, the available literature does not provide conclusive evidence of a link between adenomyosis and AUB. This is because of unsuitable study design, or poor characterization of the study population or of the inclusion or exclusion criteria. Additional challenges arise because of the lack of agreed criteria for diagnosing adenomyosis and the often absence of detailed assessment of menstrual blood loss. Adenomyosis often coexists with other conditions that have also been linked to similar symptoms, and many cases of adenomyosis are asymptomatic.
CONCLUSIONS: Most of the existing literature and studies that addressed treatment outcome of adenomyosis started from the premise that a link between the condition and AUB had been proven. Yet, published information shows that aspects such a relationship is still uncertain. Further research is needed to address the relation between AUB and adenomyosis burden (or subtypes), distribution, and concomitant pathology.
摘要：
背景：ThomasCullen将出血异常和痛经描述为腺肌瘤的“预期”表现。子宫腺肌病包括在异常子宫出血（AUB）的结构原因的FIGO分类中。然而，一些作者对这一长期存在的关联提出了质疑,他们报告子宫腺肌病的发生率很高,除了AUB或痛经以外的适应症.这里,我们研究了子宫腺肌病和AUB之间联系的证据。
方法：截至2023年10月所有出版物的全面Medline文献综述。
结果：确定了63篇文章，并纳入了综述。尽管有大量的研究，现有文献没有提供子宫腺肌病与AUB之间联系的确凿证据.这是因为不合适的研究设计，或研究人群或纳入或排除标准的不良表征。由于缺乏一致的诊断子宫腺肌病的标准以及经常缺乏对月经失血的详细评估，因此出现了其他挑战。子宫腺肌病通常与其他也与类似症状有关的疾病共存，许多子宫腺肌病病例无症状。
结论：大多数针对子宫腺肌病治疗结果的现有文献和研究都是从已证明病情与AUB之间存在联系的前提开始的。然而，公布的信息表明，这种关系在各个方面仍然不确定。需要进一步的研究来解决AUB和子宫腺肌病负担（或亚型）之间的关系，分布，和伴随的病理学。
方法：截至2023年10月所有出版物的全面Medline文献综述。
结果：确定了63篇文章，并纳入了综述。尽管有大量的研究，现有文献没有提供子宫腺肌病与AUB之间联系的确凿证据.这是因为不合适的研究设计，或研究人群或纳入或排除标准的不良表征。由于缺乏一致的诊断子宫腺肌病的标准以及经常缺乏对月经失血的详细评估，因此出现了其他挑战。子宫腺肌病通常与其他也与类似症状有关的疾病共存，许多子宫腺肌病病例无症状。
结论：大多数针对子宫腺肌病治疗结果的现有文献和研究都是从已证明病情与AUB之间存在联系的前提开始的。然而，公布的信息表明，这种关系在各个方面仍然不确定。需要进一步的研究来解决AUB和子宫腺肌病负担（或亚型）之间的关系，分布，和伴随的病理学。
