Document Detail

Adenomyosis: new knowledge is generating new treatment strategies.
MedLine Citation:
PMID:  19392615     Owner:  NLM     Status:  MEDLINE    
In the early days, all mucosal invasions of abdominal organs were considered to be one pathological condition of uncertain origin, termed adenomyoma. It was only in the 1920s that endometriosis and adenomyosis were clearly separated and it took approximately 80 years to put forward a new theory reunifying their pathogenesis. Today, identification of adenomyosis is carried out exclusively through vaginal ultrasonography and MRI. These techniques have made a careful evaluation of a distinct anatomical structure and the inner myometrial layers underlying the endometrium, termed the junctional zone, possible. Adenomyosis is characterized by a homogeneous thickening of this portion of the myometrium. When this hyperplasia is associated to an alteration of spiral arterioles' angiogenesis, then both adenomyosis and endometriosis may develop. Evidence is being accumulated that pre-eclampsia, fetal growth restriction and premature delivery may be linked, together representing a new, major obstetrical syndrome characterized by a modified uterine environment around the time of nidation. A dozen different medical or surgical techniques are utilized for the treatment of adenomyosis and novel approaches are being tested. These include use of inhibitors of angiogenesis that have been shown to cause reduced neo-angiogenesis, a significant modification of gene expression and a decrease in the percentage of active lesions. Encouraging results have also been obtained with the levonorgestrel-releasing intrauterine system.
Giuseppe Benagiano; Ivo Brosens; Sabina Carrara
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Women's health (London, England)     Volume:  5     ISSN:  1745-5065     ISO Abbreviation:  -     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-27     Completed Date:  2009-07-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101271249     Medline TA:  Womens Health (Lond Engl)     Country:  England    
Other Details:
Languages:  eng     Pagination:  297-311     Citation Subset:  IM    
Department of Gynecology & Obstetrics, Sapienza University of Rome, Rome, Italy.
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MeSH Terms
Endometriosis* / complications,  diagnosis,  epidemiology,  therapy
Infertility, Female / etiology
Menstruation / physiology
Myometrium / pathology
Pregnancy Complications / etiology
Stem Cells / cytology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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