Patoloji Tanısı Adenomyozis ya da Leiomyoma Uteri Olan Histerektomize Olgularda, Klinik Semptomatolojinin ve Transvajinal Ultrasonografik Değerlendirmenin Retrospektif Korelasyonu

Öz

ÖZ Amaç: Adenomyozis ve leiomyoma uteri hastalarında semptomların ve ultrasonografi bulgularının doğru kombinasyonu sonucunda tanının doğru konulması tedaviye yön gösterecektir. Biz bu amaçla, çalışmamızda klinik semptomların ve Transvajinal Ultrasonografi (TVUSG) bulgularının, patoloji sonuçları ile karşılaştırılması amaçlanmıştır. Gereç ve Yöntemler: Akdeniz Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Kliniğinde, benign nedenlerle histerektomi operasyonu olan ve sitopatolojik inceleme sonucu, leiomyoma uteri ve/veya adenomyozis olarak rapor edilen olgular retrospektif olarak değerlendirilmiştir. Bulgular: İki yüz bir olgunun histerektomi materyalinin incelenmesinde; 94 olguda (%46,8) leiomyoma uteri, 33 olguda adenomyozis (%16,4), 37 olguda (%18,4) leiomyoma uteri+adenomyozis saptanmıştır. Parite sayısı (mean±Sd: 3,36±1,912 ve 2,07±1,065; p<0.01), kronik pelvik ağrı şikâyeti (%68 ve %21,3; p<0,01), dilatasyon&küretaj sayısı (mean±Sd: 1,52±1,503 ve 0,76±1,022; p<0,01) adenomyozisli hastalarda leiomyoma uteri grubuna göre yüksek bulunmuştur. Transvajinal ultrasonografik değerlendirmenin leiomyoma uteri ve adenomyosis tanısında sensitivite değerleri sırasıyla %97,2 ve %34,5; spesifitesi değerleri sırasıyla %88 ve %100 olarak bulunmuştur. TVUSG’nin leiomyoma uteri tanısında genel doğruluk oranı % 95,5 adenomyozis tanısında genel doğruluk oranı %82,6’dır. Sonuçlar: Kronik pelvik ağrı şikâyeti adenomyozisin önemli bir semptomudur. Adenomyozis olgularının parite sayısı ve dilatasyon ve küretaj öyküleri fazladır. Transvajinal ultrasonografik değerlendirmenin doğruluk oranı leiomyoma uteri tanısında adenomyozisin tanısına karşın daha yüksektir.

Anahtar Kelimeler

• Adenomyozis
• Leiomyoma uteri
• Transvajinal ultrasonografi

Retrospective Correlation of the Clinical Symptomatology and the Transvaginal Ultrasonographic Findings of the Hysterectomised Patients with the Pathologic Diagnosis of Adenomyosis or Leiomyoma Uteri

Öz

ABSTRACT Objective: True diagnosis as a result of the combination of symptoms and ultrasonography findings in patients with adenomyosis and leiomyoma uteri will guide the treatment. For this purpose, we aimed to compare clinical symptoms and Transvaginal Ultrasonography (TVUSG) findings with pathology results in our study. Material and Methods: Cases who underwent hysterectomy for benign reasons and were reported as leiomyoma uteri and/or adenomyosis in cytopathological evaluation at Akdeniz University Faculty of Medicine, Gynecology and Obstetrics Clinic were retrospectively evaluated. Results: In the examination of hysterectomy specimens of 201 cases; Leiomyoma uteri was detected in 94 cases (46.8%), adenomyosis in 33 cases (16.4%), and leiomyoma uteri+adenomyosis in 37 cases (18.4%). Number of parity (mean±Sd: 3.36±1.912 vs 2.07±1.065; p<0.01), chronic pelvic pain complaint (68% vs 21.3%; p<0.01), number of dilatation&curettage (mean±Sd: 1.52 ±1.503 vs 0.76±1.022; p<0.01) were found to be higher in adenomyosis patients than in the leiomyoma uteri group. The sensitivity values of transvaginal ultrasonographic evaluation in the diagnosis of leiomyoma uteri and adenomyosis were 97.2% and 34.5%, respectively; specificity values were found to be 88% and 100%, respectively. The overall accuracy rate of TVUSG was 95.5% for leiomyoma uteri and 82.6% for adenomyosis. Conclusions: Chronic pelvic pain is an important symptom of adenomyosis. Adenomyosis cases have a high parity number and dilatation and curettage history. The accuracy rate of transvaginal ultrasonographic evaluation is higher in the diagnosis of leiomyoma uteri than in the diagnosis of adenomyosis.

Anahtar Kelimeler

• Adenomyosis
• Leiomyoma uteri
• Transvaginal ultrasonography

Kaynakça

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