Clinical Manifestations Of Adenomyosis Patients With Or Without Pain Symptoms
Received 13 April 2019
Accepted for publication 1 October 2019
Published 14 November 2019 Volume 2019:12 Pages 3127—3133
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Editor who approved publication: Dr Michael A Überall
Qian Chen,* Yun-Wei Li,* Shu Wang, Qing-Bo Fan, Hong-Hui Shi, Jin-Hua Leng, Da-Wei Sun, Jing-He Lang, Lan Zhu
Department of Gynecology and Obstetrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Shu Wang; Qing-Bo Fan
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 1 ShuaiFuYuan, Wangfujing, DongCheng District, Beijing 100730, People’s Republic of China
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Purpose: Our study aims to investigate the distribution of pain symptoms and the association between pain symptoms and clinical parameters in patients with adenomyosis.
Patients and methods: The clinical and pathological data of 291 patients diagnosed with adenomyosis in the Obstetrics and Gynecology Department of Peking Union Medical College Hospital from March 2012 to September 2015 were collected, and analyzed in regard to the pain symptoms.
Results: The median age at disease onset was 34 years. 71.8% of the patients had pain symptoms (pain group) and 28.2% had no pain symptoms (painless group). Patients with symptoms accompanied by dysmenorrhea accounted for 68%, among which 30.3% were mild, 36.9% were moderate, and 32.8% severe, while 56.1% presented with progressive pain. Through comparison, significant differences were identified between the pain and painless groups with regard to age at diagnosis (P=0.009), age at onset of disease (P=0.008), and level of pre-surgical CA125 (P<0.001), as well as proportion of patients with rectal irritation (P=0.008), elevated CA125 level (P<0.001), thickened myometrial layer (P<0.001) and concurrent endometriosis (P=0.001). In the multivariable analysis, an elevated level of pre-surgical CA125 (P<0.001) and thickened posterior myometrial layer (P=0.023) were both independent risk factors for the morbidity of pain symptoms. Similar results except for the difference in rectal irritation were noticed when we made further comparison between the dysmenorrhea and non-dysmenorrhea groups in adenomyosis patients.
Conclusion: Our research analyzes the clinical features related to pain symptoms in patients with adenomyosis, which may provide clues for the possible presurgical diagnosis of adenomyosis, as well as references for pain management of adenomyosis.
Keywords: adenomyosis, pain symptoms, clinical features, risk factors
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