目的:简要概述高发病率,症状学,不同类型,和子宫腺肌病的诊断和探讨疾病的各个方面,主要目的是提高妇科医生对适当和早期发现的认识。
背景:子宫腺肌病,一种良性妇科疾病,其特征是子宫内膜组织渗入子宫肌层,对妇女的生殖健康构成重大挑战。
方法:通过搜索PubMed,Scopus,和Cochrane数据库,并提供了关于子宫腺肌病对妇女健康影响的现有知识的非系统总结和批判性分析。截至2023年5月以英语发表的文章,包括原创科学论文,临床试验,荟萃分析,并对子宫腺肌病的各个方面进行了综述,被列入这篇综述的综合报告。
结论:大约有20%的女性患有子宫腺肌病,表现为各种亚型,不同的流行病学概况,症状学,和治疗反应。尽管具有临床意义,子宫腺肌病仍未得到充分研究,与其他妇科疾病相比,研究和文献存在显着差异。当与子宫内膜异位症共存时,子宫腺肌病的严重程度会加重,特别是深部浸润型子宫内膜异位症(DIE),导致恶化的生育问题和严重的症状。广泛的症状,包括不良妊娠结局,如先兆子痫,强调其更广泛的影响,并强调需要提高对这种情况的认识。子宫腺肌病通常与子宫内膜异位症的治疗失败有关,导致最大的抵抗力,停药率升高,子宫内膜异位症手术后持续性疼痛。此外,缺乏针对子宫腺肌病的特异性治疗方法给临床治疗带来了相当大的挑战.
OBJECTIVE: To provide a brief summary of the high incidence, symptomatology, different types, and diagnosis of adenomyosis and to explore various aspects of the disease, with the primary aim of raising awareness among gynecologists for appropriate and early detection.
BACKGROUND: Adenomyosis, a benign gynecological condition characterized by the infiltration of endometrial tissue into the myometrium, poses significant challenges to women\'s reproductive health.
METHODS: A narrative review was conducted by searching PubMed, Scopus, and Cochrane databases and offering a non-systematic summary and critical analysis of current knowledge on the impact of adenomyosis on women\'s health. Articles published in the English language up to May 2023, including original scientific papers, clinical trials, meta-analyses, and reviews focusing on various aspects of adenomyosis, were included in the synthesis of this review.
CONCLUSIONS: Approximately 20% of women are affected by adenomyosis, which manifests with various subtypes, distinct epidemiological profiles, symptomatology, and treatment responses. Despite its clinical significance, adenomyosis remains understudied, resulting in a significant disparity in research and the literature compared to other gynecological conditions. The severity of adenomyosis is compounded when coexisting with endometriosis, particularly deep-infiltrating endometriosis (DIE), leading to exacerbated fertility issues and severe symptomatology. The wide range of symptoms, including adverse pregnancy outcomes such as pre-eclampsia, highlights its wider impact and emphasizes the need for increased awareness of the condition. Adenomyosis is frequently associated with treatment failure in endometriosis, contributing to dienogest resistance, elevated discontinuation rates, and persistent pain post-endometriosis surgery. Additionally, the lack of specific treatments tailored to adenomyosis poses a considerable challenge in clinical management.