Does Endometrial Resection Cause Adenomyosis?

Nine cases of adenomyosis after endometrial resection are examined. Patients' symptoms were menorrhagia prior to initial resection, and patients had normal ultrasounds prior to their first procedure. All of the patients underwent resection without hormonal preparation. None had adenomyosis on resection specimens. After resection, five complained of cyclic pelvic pain, and four had dysmenorrhea. The onset of symptoms varied from 7 to 60 months. Ultrasound findings consistent with adenomyosis were reported in seven patients. Five patients had repeat resection procedures; specimens all showed adenomyosis on tissue report. Two patients are asymptomatic after the repeat resection. One patient continues on suppressive therapy with partial relief of symptoms. Two required hysterectomy for continued pain. In total, six patients required hysterectomy for continued dysmenorrhea or pelvic pain; at surgery the diagnosis of adenomyosis was confirmed.