Adenomyosis is a condition where cells from the endometrium migrate into the muscular layer of the uterus and begin to spread and grow. This can cause the uterus to enlarge due to the myometrium thickening as these rogue cells multiply.
This tissue mimics the characteristics of the uterine lining because it is made up of the same type of cells. This can cause abnormally heavy bleeding during menstruation (Menorrhagia) as well as abdominal pain and cramping.
Adenomyosis has no known cause but experts know that the condition is sensitive to estrogen and studies have also shown that the condition often affects women who have had at least one child and also those who have undergone some form of uterine surgery such as a c-section.
Adenomyosis is often misdiagnosed because its symptoms mimic many other gynecologic conditions. Today we are going to look at one such case of adenomyosis misdiagnosis and how this patient received an accurate diagnosis and whose symptoms were relieved by Dr. John Lipman at the Atlanta Fibroid Center.
Misdiagnosed Adenomyosis Is The Cause Of Woman’s Symptoms
A 45-year-old woman had symptoms of heavy bleeding and severe menstrual cramps in the lower abdomen. She had undergone multiple blood and iron transfusions due to anemia resulting from blood loss.
An ultrasound was performed in her OB-Gyn’s office and she was incorrectly diagnosed with a large posterior fibroid.
Uterine fibroids are non-cancerous growths that can be found in and on the uterus. The cause of fibroids is unknown but they are known to grow large when they are exposed to excess estrogen. Large or numerous fibroids can cause heavy bleeding, abdominal pain, and a host of other unpleasant symptoms.
This patient had also tried three months of Lupron which is a GnRH agonist used to inhibit the growth of cancerous cells. It is often used to help manage some of the symptoms of endometriosis including pain. These treatments were unsuccessful.
The Patient Meets The Atlanta Fibroid Center Team of Professionals
An MRI scan found several tiny fibroids and thick adenomyosis (up to 40mm) which was an accurate diagnosis.
Comparing the pictures below, you will notice a marked difference between the picture on the left which shows the thick dark adenomyosis, and the right-hand picture with the normal homogenous whitish-gray muscular layer. This is also responsible for the uterine enlargement seen in adenomyosis.
The next images show a side view (left) and a transverse view (right). You will notice the thickening involves more of the posterior portion of the uterus which was what caused the misinterpretation on the ultrasound scan to be a posterior fibroid.
You can also see the enlarged uterus is pressing on the bladder. The white structure in front of the uterus, bottom left of the image.
The white dots seen in the thick adenomyosis are the myometrial cysts which are diagnostic (clear signs) of adenomyosis. The tiny black circle in the anterior portion of the uterus is an incidental fibroid. A fibroid being a ball-like tumor with sharp margins is more clearly defined while adenomyosis is a more infiltrative process; therefore not as sharply marginated.
Uterine Artery Embolization Is Used To Treat Adenomyosis
The images below show a side-by-side comparison of the patient before and after uterine artery embolization.
The image on the left is the same side view as shown previously and was taken before UAE. The image on the right was taken 3 months after the patient underwent uterine artery embolization (UAE). The scan shown on the right was done with IV contrast which shows several findings including:
- The uterus is significantly smaller and almost normal again in size;
- The adenomyosis that remains is dead (non-enhancing) while the surrounding uterus is alive and enhanced with contrast;
- The tiny fibroid is also dead from the UAE procedure.
The below transverse images show another view of the before and after uterine artery embolization of the images above. The scan on the right was taken 3 months after UAE.
Uterine artery embolization is an effective and safe adenomyosis surgery alternative. It is less invasive and offers a significantly shorter recovery time than surgery.
Adenomyosis Surgery Vs Uterine Artery Embolization
When comparing adenomyosis surgery vs uterine artery embolization, UAE offers many advantages. Let’s look at the surgical treatments available for adenomyosis.
- The most common surgery performed to treat adenomyosis is a hysterectomy (total removal of a woman’s uterus) This drastic treatment will render the patient unable to have a baby if they desire in the future. Also, the uterus has been linked to many other women’s health conditions including heart health, memory issues, and more.
- An adenomyomectomy is another surgical treatment used to remove abnormal tissue. Different techniques can be used to remove the abnormal adenomyosis tissue from the uterus and the procedure is often unable to remove all the abnormal tissue and many patients experience the recurrence of adenomyosis tissue growth.
An adenomyomectomy can also result in an intraoperative hemorrhage, the formation of abdominal adhesions that are painful and can cause infertility, uterine rupture during pregnancy, etc.
UAE Is Safe And Effective When Performed By An Expert
Uterine artery embolization is a procedure that is done as an outpatient and does not require a hospital stay. Dr. John Lipman and Dr. Mitchell Ermentrout at the Atlanta Fibroid Center have combined experience helping women with adenomyosis and uterine fibroids of over 40 years.
Dr. Lipman is one of the world’s leading experts on the UAE procedure and has a plethora of positive uterine artery embolization patient reviews and known for his expertise both nationally and internationally.
When performed by an expert Interventional Radiologist, UAE can eliminate the debilitating symptoms associated with adenomyosis or uterine fibroids.
The UAE procedure normally takes about 45 minutes and the patient leaves to recover comfortably at home within a few hours with only a bandaid as evidence of the procedure. During the procedure, the blood supply that is feeding the adenomyosis and keeping it alive is cut off. Without this vital source of blood, the tissue begins to shrink and eventually dies. As the adenomyosis shrinks and dies, the associated symptoms shrink and die as well.
If you have been diagnosed with fibroids or adenomyosis, or you feel you may have been misdiagnosed, contact The Atlanta Fibroid Center today to learn more about uterine artery embolization.
The knowledgeable professionals at the Atlanta Fibroid Center can help determine if you may be a candidate for uterine artery embolization. (The best adenomyosis surgery alternative available today) Set up your consultation today!