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Adenomiosis

Endometriosis interna; Adenomioma, Dolor pélvico - adenomiosis

Definición

Es un engrosamiento de las paredes del útero. Ocurre cuando el tejido endometrial crece en las paredes musculares externas del útero. El tejido endometrial forma el revestimiento del útero.

Causas

No se conoce la causa. Algunas veces, la adenomiosis puede causar que el útero aumente de tamaño.

La afección ocurre con más frecuencia en mujeres de 35 a 50 años que han tenido al menos un embarazo.

Síntomas

En muchos casos, no se presentan síntomas. Cuando hay síntomas, estos pueden incluir:

Sangrado menstrual abundante o prolongado
Menstruación dolorosa, que empeora progresivamente
Dolor pélvico durante la relación sexual

Pruebas y exámenes

El proveedor de atención médica realizará el diagnóstico si una mujer presenta síntomas de adenomiosis que no son provocados por otros problemas ginecológicos. La única manera de confirmar el diagnóstico es examinar el tejido del útero tras una cirugía para removerlo.

Durante un examen pélvico, el proveedor puede encontrar un útero blando y ligeramente agrandado. El examen también puede revelar una masa uterina o sensibilidad del útero.

Un ultrasonido del útero puede realizarse. Sin embargo, es posible que no pueda dar un diagnóstico claro de adenomiosis. Una RM puede ser útil para ayudar a distinguir esta afección de otros tumores uterinos. Se utiliza a menudo cuando un examen de ultrasonido no proporciona suficiente información para realizar un diagnóstico.

Tratamiento

La mayoría de las mujeres presenta algo de adenomiosis a medida que se acerca a la menopausia. Sin embargo, solo algunas tienen síntomas. La mayoría no requiere ningún tratamiento.

Las píldoras anticonceptivas y un DIU que contenga progesterona pueden ayudar a disminuir el sangrado abundante. Los medicamentos como el ibuprofeno o el naproxeno también pueden ayudar a manejar el dolor.

La cirugía para remover el útero (histerectomía) puede realizarse en mujeres con síntomas graves.

Expectativas (pronóstico)

En la mayoría de los casos, los síntomas desaparecen tras la menopausia. La cirugía para remover el útero a menudo alivia por completo los síntomas.

Cuándo contactar a un profesional médico

Comuníquese con su proveedor si usted desarrolla síntomas de adenomiosis.

Referencias

Bulun SE. Physiology and pathology of the female reproductive axis. In: Melmed S, Auchus RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 17.

Dolan MS, Hill CC, Valea FA. Benign gynecologic lesions: vulva, vagina, cervix, uterus, oviduct, ovary, ultrasound imaging of pelvic structures. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 18.

Gambone JC. Endometriosis and adenomyosis. In: Hacker NF, Gambone JC, Hobel CJ, eds. Hacker & Moore's Essentials of Obstetrics and Gynecology. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 25.

Wei PK, Savicke AM, Levine D. The uterus. In: Rumack CM, Levine D, eds. Diagnostic Ultrasound. 6th ed. Philadelphia, PA: Elsevier; 2024:chap 28.

Programe una cita

Actualizado : 4/16/2024

Versión en inglés revisada por : John D. Jacobson, MD, Professor Emeritus, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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