What if deep endometriotic nodules and uterine adenomyosis were actually two forms of the same disease?


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Volume 111, Issue 3, Pages 454–456


Jacques Donnez, M.D., Ph.D., Marie-Madeleine Dolmans, M.D., Ph.D., Latifa Fellah, M.D.


Some symptoms of endometriosis, such as severe dysmenorrhea, overlap with those of uterine adenomyosis, a disease characterized by growth of endometrium into the myometrium. From a histologic point of view, deep rectovaginal endometriotic nodules were described by Donnez et al. (1) back in 1996 as “adenomyomas,” consisting of smooth muscle hyperplasia with active glandular epithelium and scanty stroma. In fact, the histologic patterns of deep endometriosis and uterine adenomyosis appear to be very similar.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. 


Go to the profile of Jasper Verguts
almost 3 years ago

Linking those two diseases without underlying common pathway is dangerous. Just because they seem to appear together quite often, is no proof.

In my experience DIE does not seem to be associated with adenomyosis as I routinely perform MRI in all cases of endometriosis. 

Also, in case of adenomyosis, the chance of finding deep rectovaginal endometriosis seems low.