Possible Adenomyosis

Hello i m 27 years old and was diagnosed with Endometriosis at the age of 19 after a laparoscopy. I was able to concive and had a baby via c section in 2006. During my c section i began to hemorrhage as my placenta had fused/grown into the uterine wall and muscle. The Doc thought it was placenta accreta however the tests i my placenta came back negative for same. Recently i have experienced continued crippling pain as i usually do however i have began experiencing a new stabbing pain to my pelvic region along with frequent bloating, pain with urination and BM's. My menstral cycles have always been heavy and long. The specialist i saw suggested the possibility of Adenomyosis and i have yet to complete the ordered ultrasound. The Doc that i saw who suspected placenta accreta never folowed up so i am wondering if in your opinion....is it likely Adenomyosis? Is te placenta fusing or growing into the uterine wall common with Andenomyosis?

[Elaine Brown, MD]

Hi!
Adenomyosis is a form of endometriosis.  Pathologically it is endometrial glands that are abnormally located within the muscle wall of the uterus. MANY women have some degree of adenomyosis, and we're not sure why.  Some studies suggest that it could be placental scarring that causes adenomyosis.  So, in your case, I think it is more likely that the abnormally implanted placenta caused the adenomyosis than vice versa.
It is difficult to see adenomyosis on ultrasound, and the only definitive way to diagnose it is with a hysterectomy.  Likewise that is the only cure, although some of the treatments for endometriosis ( OCs, Lupron) will help alleviate symptoms in some cases.
In fact, if I am contemplating hysterectomy and want to be sure that it will help solve the problem I will often pre-treat with GnRH agonists (lupron).  If those work, then surgery will probably be helpful,  if not--it won't.
I hope this is helpful!
Dr B