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

Yıl 2025, Cilt: 11 Sayı: 1, 110 - 116, 24.01.2025

Serap Fırtına Tuncer

https://doi.org/10.53394/akd.1511767

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

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

Teşekkür

Teşekkür: Bu çalışmaya kaynak olan kadın hastalıkları ve doğum uzmanlık tezimde, tez danışmanı olan Sayın Hocam Prof. Dr. Bilal TRAK uzmanlık sınavımdan kısa bir süre önce vefat etmiştir. Uzmanlık tezimde ve dolayısıyla da bu çalışmada tecrübesi ile bana yol göstermiştir. Sayın Hocam Prof. Dr. Bilal TRAK’ı saygı ve rahmetle anıyorum. Kendisi vefat etmiş olması nedeniyle onayı alınamadığından dergi editörünün bilgisi ve kararı doğrultusunda yazar isimlerine dahil edilmemiştir. Bilime katkı sağlaması amacıyla hazırladığımız bu çalışmamızda yer alan hastalara, sağlık hizmeti sunulmasında emeği olan hastanemiz tüm akademik personellerine ve sağlık çalışanlarına teşekkür ederiz.

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