Adenomyosis
What is Adenomyosis?
Adenomyosis is a condition in which part of the endometrium, or the lining of the uterus, becomes implanted in the muscle wall. This results in small pockets of bleeding within the muscle at period time, resulting in painful periods that may also be heavy. Ongoing pelvic pain between periods and spotting is also possible. Adenomyosis may occur throughout the uterine muscle (so-called diffuse adenomyosis) or may be more focal resulting in a localised adenomyoma.
How common is Adenomyosis?
Adenomyosis often occurs in association with uterine fibroids and both appear to grow in response to oestrogen. Diagnosis of adenomyosis can be difficult on ultrasound alone and it is often only confirmed on MRI scanning. It is not unusual for patients referred with a diagnosis of uterine fibroids to be found to have coexisting adenomyosis when an MRI scan is performed. A small number of patients referred for treatment of uterine fibroids are found to have pure adenomyosis on MRI scanning and do not in fact have fibroids at all. Adenomyosis is most common in women between the ages of 35 and 50 and is also more common in women who have been pregnant or who have had Caesarean deliveries.
Uterine Artery Embolisation for Adenomyosis
Uterine artery embolisation is now a well established treatment for uterine fibroids, but is also a recognised treatment for adenomyosis. There is dedicated NICE guidance on the use of uterine artery embolisation for the condition.
Apart from some minor technical alterations to procedural technique, such as the choice of size of the embolisation particles, the procedure is essentially the same for both conditions and information in the following pages applies to uterine artery embolisation of either uterine fibroids or adenomyosis. As the two conditions often occur together both can be treated with the same procedure.
