Nigerian medical journal : journal of the Nigeria Medical Association · 2026
Clinical Profile and Management Outcomes of Women with Adenomyosis: A Prospective Review from a Fertility Centre in Nigeria.
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Elachi Felix Adaoje, Ayuba Clement Fateh, Egwuda Keneth, Ifezoke Tochukwu Dickson, Ekele Innocent Ojogbane, Dunah Aboki Ali, Dawuud Rukaiyah Miko, Azaki David, Gazali Sakina, Mukaddas H, Evule Chinonye Lawson
Аннотация
BACKGROUND: Adenomyosis is seen in women with infertility, with a significant impact on their lives. This study aims to evaluate the clinical characteristics, management strategies, and treatment outcomes of women diagnosed with adenomyosis.
METHODOLOGY: This prospective study, conducted at Alps Hospitals and Diagnostics from June 2021 to December 2024, involved 44 women with adenomyosis. The clinical data were collected, reviewed, and analysed.
RESULTS: The mean age of participants was 39.5 ± 5.1 years. Most (77.3%) participants were nulliparous, with a mean duration of infertility of 7.4 ± 4.2 years. The most common (63.6%) presenting symptom was combined dysmenorrhoea and menorrhagia. Ultrasonography identified adenomyosis in 54.5% of cases.Diffuse adenomyosis was seen in 52.3% of women. Myomas were the most common (79.5%) co-existing pelvic pathology. Double-flap adenomyomectomy and wedge resection were done in 54.5% and 29.5% of participants, respectively. 13.6% of participants had medical treatment. Surgical site infection was the most frequent (6.8%) post-operative complication.Double flap adenomyomectomy and wedge resection resulted in reductions in Visual Analogue Scale (VAS) scores for dysmenorrhoea and menorrhagia. There was no significant difference (p-value> 0.05) when both surgical options were compared. GnRH analogues resulted in temporary symptom relief. Three women had positive pregnancy tests following In Vitro Fertilization (IVF), out of which 1 resulted in a live birth and 2 ended in miscarriages.
CONCLUSION: Adenomyosis predominantly affects infertile nulliparous women in the late third decade of life with previous uterine surgeries. Combined menorrhagia and dysmenorrhoea are a common presentation, and conservative surgeries may provide sustained symptom relief with limited improvement in reproduction.
METHODOLOGY: This prospective study, conducted at Alps Hospitals and Diagnostics from June 2021 to December 2024, involved 44 women with adenomyosis. The clinical data were collected, reviewed, and analysed.
RESULTS: The mean age of participants was 39.5 ± 5.1 years. Most (77.3%) participants were nulliparous, with a mean duration of infertility of 7.4 ± 4.2 years. The most common (63.6%) presenting symptom was combined dysmenorrhoea and menorrhagia. Ultrasonography identified adenomyosis in 54.5% of cases.Diffuse adenomyosis was seen in 52.3% of women. Myomas were the most common (79.5%) co-existing pelvic pathology. Double-flap adenomyomectomy and wedge resection were done in 54.5% and 29.5% of participants, respectively. 13.6% of participants had medical treatment. Surgical site infection was the most frequent (6.8%) post-operative complication.Double flap adenomyomectomy and wedge resection resulted in reductions in Visual Analogue Scale (VAS) scores for dysmenorrhoea and menorrhagia. There was no significant difference (p-value> 0.05) when both surgical options were compared. GnRH analogues resulted in temporary symptom relief. Three women had positive pregnancy tests following In Vitro Fertilization (IVF), out of which 1 resulted in a live birth and 2 ended in miscarriages.
CONCLUSION: Adenomyosis predominantly affects infertile nulliparous women in the late third decade of life with previous uterine surgeries. Combined menorrhagia and dysmenorrhoea are a common presentation, and conservative surgeries may provide sustained symptom relief with limited improvement in reproduction.