Adenomyozise Eşlik Eden Jinekolojik Patolojiler
Özet
Amaç: Bu çalışma, Total Abdominal Histerektomi (TAH) ve TAH ile birlikte Bilateral Salpingooforektomi (BSO) yapılan hastalarda patoloji sonuçlarına göre adenomyozis tanısı konulan olgularda eşlik eden ek jinekolojik patolojilerin sıklığını ve dağılımını araştırmayı hedeflemektedir.
Gereç ve Yöntemler: Aralık 2013-Temmuz 2015 tarihleri arasında çeşitli endikasyonlarla histerektomi uygulanan 202 hastanın dosyaları retrospektif olarak incelenmiştir. Adenomyozis tanısı konulan 101 olgu çalışmaya dahil edilmiş, bu olguların demografik verileri ve eşlik eden patolojiler kaydedilmiştir.
Bulgular: İncelenen olguların yaş ortalaması 49.69±7.54, gravida ortalaması 3.53±1.57, parite ortalaması 3.00±1.41 ve vücut kitle indeksi ortalaması 23.34±3,28 olarak belirlenmiştir. Adenomyozis tanısı konulan olgularda en sık rastlanan ek patolojiler; leiomyoma (%47,5), kronik servisit (%77,2) ve endometriozis (%29,7) olarak tespit edilmiştir.
Sonuç: Adenomyozis, sıklıkla diğer jinekolojik patolojilerle birlikte görülmekte olup, özellikle multipar kadınlar, leiomyoma sahibi olanlar ve düşük vücut kitle indeksine sahip bireyler yüksek risk altındadır. Medikal tedaviye direnç gösteren ve şikayetleri devam eden hastaların adenomyozis açısından değerlendirilmesi ve tedavi planlamasında bu birlikteliğin göz önünde bulundurulması önerilmektedir.
Objective: This study aims to investigate the frequency and distribution of additional gynecological pathologies accompanying cases diagnosed with adenomyosis following Total Abdominal Hysterectomy (TAH) and TAH with Bilateral Salpingo-oophorectomy (BSO).
Materials and Methods: The files of 202 patients who underwent hysterectomy for various indications between December 2013 and July 2015 were retrospectively reviewed. A total of 101 cases diagnosed with adenomyosis were included in the study, and their demographic data and accompanying pathologies were recorded.
Findings: The age range of the patients varied from 32 to 79, with an average age of 49.69±7.54; the average number of gravidas was 3.53±1.57, the average number of parities was 3.00±1.41, and the average body mass index was 23.34±3.28. The histopathological examination of postoperative pathology specimens revealed that 47.5% had leiomyoma, 8.9% had endometrial hyperplasia, 29.7% had endometriosis, 77.2% had chronic cervicitis, 11.8% had ovarian cysts, 1.0% had endometrial cancer, and 9.9% had other nonspecific findings accompanying adenomyosis.
Conclusion: Adenomyosis is frequently observed with other gynecological pathologies, and therefore, it can be present in conjunction with them. However, significant endometrial pathology is not observed in three-quarters of patients with adenomyosis. Multiparous women, those with leiomyomas, and those with a low body mass index are at high risk for developing adenomyosis. The most common accompanying endometrial pathology is endometrial hyperplasia, and the most common uterine pathology is leiomyoma. It would be appropriate to consider adenomyosis in patients whose symptoms persist after medical treatment for gynecological pathologies and who show resistance to treatment. This coexistence should be taken into account in treatment planning.
Referanslar
Zaloudek C and Hendrickson MR. Mesenchymal tumors of the uterus. In Blausteins’ pathology of the female genital tract. Kurman RJ ed. Fifth edition 2002; 561.
Azziz R. Adenomyosis: Current perspectives. Obstet Gynecol Clin North Am 1989;16:221–235.
Benagiano G, Brosens I. The endometrium in adenomyosis. Womens Health (Lond Engl) 2012;8:301-312.
Atri M, Reinhold C, Mehio AR, Chapman WB, Bret PM. Adenomyozis: US features with histologic correlation in an in vitro study. Radiology 2000;215:783-790.
Abbott JA. Adenomyosis and Abnormal Uterine Bleeding (AUB-A)-Pathogenesis, diagnosis, and management. Best Pract Res Clin Obstet Gynaecol. 2017 Apr;40:68-81. doi: 10.1016/j.bpobgyn.2016.09.006. Epub 2016 Sep 30. PMID: 27810281.
Halvorson LM, Giudice LC, Stewart EA. Eye to the Future in Adenomyosis Research. Semin Reprod Med. 2020 May;38(2-03):197-200. doi: 10.1055/s-0040-1721503. Epub 2020 Dec 11. PMID: 33307559.
Jason M, Dechenne V, Chantraine F, Nisolle M. Le cas clinique du mois. L'adénomyose [Adenomyosis]. Rev Med Liege. 2013 Apr;68(4):160-2. French. PMID: 23755704.
Habiba M, Guo SW, Benagiano G. Are Adenomyosis and Endometriosis Phenotypes of the Same Disease Process? Biomolecules. 2023 Dec 25;14(1):32. doi: 10.3390/biom14010032. PMID: 38254632; PMCID: PMC10812963.
Wei A, Tang X, Yang W, Zhou J, Zhu W, Pan S. Efficacy of etonogestrel subcutaneous implants versus the levonorgestrel-releasing intrauterine system in the conservative treatment of adenomyosis. Open Med (Wars). 2024 Mar 21;19(1):20240914. doi: 10.1515/med-2024-0914. PMID: 38584829; PMCID: PMC10996985.
Mitranovici MI, Chiorean DM, Moraru L, Moraru R, Caravia L, Tiron AT, Cotoi TC, Toru HS, Cotoi OS. Shared Pathogenic and Therapeutic Characteristics of Endometriosis, Adenomyosis, and Endometrial Cancer: A Comprehensive Literature Review. Pharmaceuticals (Basel). 2024 Feb 28;17(3):311. doi: 10.3390/ph17030311. PMID: 38543097; PMCID: PMC10976130.
Munro MG. Uterine polyps, adenomyosis, leiomyomas, and endometrial receptivity. Fertil Steril. 2019 Apr;111(4):629-640. doi: 10.1016/j.fertnstert.2019.02.008. PMID: 30929720.
Wéry O, Thille A, Gaspard U, van den Brûle F. Adenomyosis: Update on a frequent but difficult diagnosis. J Gynecol Obstet Biol Reprod (Paris) 2005;34:633–648.
Rokitansky C. Zeitschrift Gesellschaft der Aerzte in Wien. 1860;16: 577.
Von Recklinghausen F: Die Adenomyomata und Cystadenomata der uterusund tußenwandung: Ihre Aßkunft von Retsen des Wolffschen Korpers. Berlin. August Hirschwald, 1896.
Cullen TS: Adenomyoma of the Uterus. Philadelphia, WB Saunders 1908.
Frankl O. Adenomyosis Uteri. Am J Obstet Gynecol 1925; 10: 680-684.
Bird CC, McElin TW, Manola-Eslrella P. The elusive adenomyosis of the uterus. Am J Obstet Gynecol 1972; 112: 583-593.
Ferenczy A, Pathophysiology of adennomyosis. Hum Reprod 1998; 4: 312- 322.
Devlieger R, D’Hooghe T, Timmermen D. Uterine adenomyosis in the infertility clin. Hum Reprod Update 2003; 9: 139-147.
Molitor JJ. Adenomyosis: A clinical and pathological appraisal. American Obstet & Gynaecol 1971; 110: 275-282.
O'Shea A, Figueiredo G, Lee SI. Imaging Diagnosis of Adenomyosis. Semin Reprod Med. 2020 May;38(2-03):119-128. doi: 10.1055/s-0040-1719017. Epub 2020 Nov 16. PMID: 33197946.
Van den Bosch T, Van Schoubroeck D. Ultrasound diagnosis of endometriosis and adenomyosis: State of the art. Best Pract Res Clin Obstet Gynaecol. 2018 Aug;51:16-24. doi: 10.1016/j.bpobgyn.2018.01.013. Epub 2018 Feb 14. PMID: 29506961.
Mark AS, Hricak H, Heinrichs LW. Adenomyosis and leiomyoma: differantial diagnoses with MR imaging. Radiology 1987; 163: 527-529.
Togashi K, Ozasa H, Konishi I, Itoh H, Nishimura K, Fujisawa C, Noma A, Sagoh A, Minami S, Yamashita E, Nakano O, Konishi U, Mori T, Enlarged Uterus: Differentiation between Adenomyosis and Lelomyoma with MR Imaging. Radiology 1989; 171: 531-534. 89
Ota H, Igarashi S, Hatazawa Z. Distribution of heat shock proteins in the eutopic and ectopic endometrium in endometriosis and adenomyosis. Fertil Steril 1997; 68: 23-28.
Rossi, M., Vannuccini, S., Capezzuoli, T. ve diğerleri. Adenomyozisin Mekanizmaları ve Patogenezi. Curr Obstet Gynecol Rep 11 , 95–102 (2022). https://doi.org/10.1007/s13669-022-00326-7
Kumar V, Cotran R, Robbins SL. Basic Pathology. Fifith edition, Philadelphia: WB. Saunders 1992: 615-616.
Pernoll ML. Obstetrik ve Jinekoloji El Kitabı. Ayhan A (Çeviren). 10. baskı, Ankara: Palme, 2002: 755-767.
Matalliotakis IM, Kourtis AL, Panidis DK. Adenomyosis. Obstet Gynecol Clin North Am 2003; 30: 63-82.
Chung YP, Linn HH, Sheu BC. Adenomyosis in the broad ligament and tamoxifen: report of a case. J Obstet Gynaecol Res 1997; 23: 69-73.
Wood C. Surgical and medical treatment of adenomyosis. Human Reproduction Update 1998; 4: 323-336.
Zaloudek C, Hendrickson MR. Mesenchymal tumors of the uterus. In Blausteins’ pathology of the female genital tract. Kurman RJ ed. Fifth edition, New York: Springer 2002; 561- 573.
Kumar V, Cotran R, Robbins SL. Basic Pathology. Fifith edition, Philadelphia: WB Saunders 1992; 615-616.
Parazzini F, Vercellini P, Panazza S, Chatenoud L, Oldani S, Crosignani PG. Risk factors for adenomyosis. Hum Reprod 1997; 12: 1275-1279.
Matalliotakis IM, Katsikis IK, Panidis DK. Adenomyosis: what is the impact on fertility? Curr Opin Obstet Gynecol 2005; 17: 261-264.
Atri M, Reinhold C, Mehio AR, Chapman WB, Bret PM. Adenomyozis: US features with histologic correlation in an in vitro study. Radiology 2000; 215: 783-790.
Speroff L, Fritz MA. Klinik Jinekolojik Endokrinoloji ve İnfertilite. Erk A, Gunalp S (Çeviren). 7. baskı, Ankara: Güneş Tıp Kitabevi, 2007; 562-605.
Reinfold C, McCarthy S, Bret PM. Diffuse adenomyosis: comparison of endovaginal US and MR imaging with histopathologic correlation. Radiology 1996; 199: 151-158.
Wood C. The expansive behaviour of the human uterus. J Obstet Gynaecol Br Cwlth J Obstet Gynaecol Br Cwlth 1964; 71: 615.
Goerttler J. Myometrial structure during pregnancy. Gegenbaurs Morphologisches Jahrbuch 1930; 65:45. 90
Harkness MLR, Harkness RD. Changes in the physical properties of the uterine cervix of the rat during pregnancy. J Physiol (Lond) 1959; 148: 524.
Wood C. Rupture of the uterus. Med J Aust 1960; 47: 166-169.
Wood C. Surgical and medical treatment of adenomyosis. Human Reproduction Update 1998; 4: 323-336.
Brosens JJ, De Souza RN, Barker FG. Uterine junctional zone: function and disease. Lancet 1995: 346; 558-560.
Popp LW, Schwiedessen JP, Gaetje R. Myometrial biopsy in the diagnosis of adenomyosis uteri. Am J Obstet Gynecol 1993; 169: 546-549.
Wood C, Maher P, Hill D. Biopsy diagnosis and conservative surgical treatment of adenomyosis. J Am Assoc Gynecol Laparosc 1994;1: 313-316.
Wood C, Rogers P. Pregnancy after planned partial endometrial resection. Aust. NZJ. Obstet Gnaecol 1993; 33: 316-318.
Wood C, Maher P. Hystercetomy. In laparoscopic Hysterecetomy. Bailiere’s Clin Obstet Gynaecol 1997; 11: 111-136.
Ravina JH, Herbreteau D, Ciraru-Vigneron N. Arterial embolisation to treat uterine myomata. Lancet 1995; 346: 671-672.
Worthington-Kirsch RL, Popky GL, Hutchins FL Jr. Uterine arterial embolization for the management of leiomyomas: quality-of-life assessment and clinical response. Radiology 1998; 208: 625-629.
Pelage JP, Le Dref O, Soyer P. Fibroid-related menorrhagia: treatment with superselective embolization of the uterine arteries and midterm followup. Radiology 2000; 215: 428-431.
Spies JB, Spector A, Roth AR. Complication after uterine artery embolization for leiomyomas. Obstet Gynecol 2002; 100: 873 -880.
A Jha RC, Takahama J, Imaoka I. Adenomyosis: MRI of the uterus treated with uterine artery embolization. AJR 2003; 181: 851 -856.
Siskin GP, Tublin ME, Stainken BF, Dowling K, Dolen EG. Uterine artery embolization for the treatment of adenomyosis: clinical response and evaluation with MR imaging. AJR 2001; 177: 297-302.
Kitamura Y, Alison S, Jha R, Spies J, Flick P, Ascher S. MRI of Adenomyosis: Changes with Uterine Artery Embolization. AJR 2006; 186: 855-864.
Lev Gur M. The enlarged uterus. Relation of uterine size to symptoms and histopathologic findings. J Reprod Med1996; 41: 166-170. 91
Fedele L, Bianchi S, Raffaeli R. Treatment of adenomyosis associated menorrhagia with a levonergestrel releasing intrauterine device. Fertil Steril 1997; 68: 426-429.
Ter Haar GR. High intensity focused ultrasound for the treatment of tumors. Echocardiography 2001; 18: 317-322.
Benrubi GI. History of hysterectomy. J Fla Med Assoc 1988;75: 533–538.
Baggish MS. Total and subtotal abdominal hysterectomy. Best Pract Res Clin Obstet Gynaecol. 2005 Jun;19(3): 333–56. Epub 2005 Mar 2.
Vessey MP, Villard-mackintosh L, McPherson K, Coulter A, Yeates D. The epidemiology of hysterectomy: findings in a large cohort study. Br J Obstet Gynaecol 1992;99: 402–407.
Easterday CL, Grimes DA. Hysterectomy in the United States. Obstet Gynecol 38 1983;62: 203–12.
Merrill Rm. Prevalence corrected hysterectomy rates and probabilities in Utah. Ann Epidemiol 2001;11: 127–135.
Farquhar C, Steiner CA. Hysterectomy rates in the United States 1990–1997. Obstet Gynecol 2002;99: 229–234.
McPherson K, Wennberg JE, Hovind OB, Clifford P. Small-area variations in the use of common surgical procedures. An international comparison of New England, England and Norway. N Engl J Med 1982;307: 1310–1314.
Dicker RC, Scally MJ, Greenspan JR, et al. Hysterectomy among women of reproductive age: trends in the United States, 1970–1978, JAMA 1982;248: 323–327.
Jones HW. Hysterectomy. In: Rock JA, Thompson JD, editors. 9th ed. Te Linde’s operative gynecology. Philadelphia: Lippincott-Raven, 2003. p.799–828
Gambone JC, Reifer RC. Hysterectomy. Clin Obstet Gynecol 1990;33: 205–211
Garry R. The future of hysterectomy. BJOG 2005 Feb;112(2):133–9.
Gimbel H,Settness A, Tabor A. Hysterectomy on benign indications in Denmark 1988–1998. Acta Obstet Gynecol Scand 2001;80: 267–272.
Makinen J, Johhansson J, Tomas C, et al. Morbidity of 10,110 hysterectomies by type 39 of approach. Hum Reprod 200116: 1473–1478.
Reich H, DeCaprio J, McGlynn F. Laparoscopic hysterectomy. J Gynecol Surg 1989;5: 213–6
Riberio S, Reich H, Rosenberg J, Guglielminetti E, Vidali A. The value of intraoperative cystoscopy at the time of laparoscopic hysterectomy. Hum Reprod 1999;14: 1727–9.
Reich H, McGlynn F, Sekel L. Total laparoscopic hysterectomy. Gynaecol Endosc 1993;2: 59–63.
Azziz R. Adenomyosis: Current perspectives. Obstet Gynecol Clin North Am 1989;16:221–235.
Giorgi M, Raimondo D, Pacifici M, Bartiromo L, Candiani M, Fedele F, Pizzo A, Valensise H, Seracchioli R, Raffone A, Martire FG, Centini G, Zupi E, Lazzeri L. Adenomyosis among patients undergoing postpartum hysterectomy for uncontrollable uterine bleeding: A multicenter, observational, retrospective, cohort study on histologically-based prevalence and clinical characteristics. Int J Gynaecol Obstet. 2024 Mar 18. doi: 10.1002/ijgo.15452. Epub ahead of print. PMID: 38494900.
Mine Genc, Berhan Genc , Hakan Cengiz Received: 22 May 2014/Accepted: 25 September 2014/Published online: 4 October 2014 Springer-Verlag Berlin Heidelberg 2014
Ellis PSJ, Whitehead R. Mitosis counting-a need for reappraisal. Human Pathol 1981; 12: 3-4.
Ferenczy A. Pathophysiology of adenomyosis. Hum Reprod Update 1998; 4: 312-22.
Bird CC, McElin TW, Manola-Eslrella P. The elusive adenomyosis of the uterus. Am J Obstet Gynecol 1972; 112: 583-593
Bergholt T, Eriksen L, Berendt N, Jacobsen M, Hertz JB. Prevalence and risk facors of adenomyosis at hysterectomy. Human Reproduction 2001; 16: 2418-21.
Emmanuel I, Ochigbo A, Philip A, Nyam EY. Adenomyosis:A Clinico-pathological Study. West Afr J Med. 2019 Jan-Apr;36(1):88-92. PMID: 30924123.
Parazzini F, Vercellini P, Panazza S, Chatenoud L, Oldani S, Crosignani PG. Risk factors for adenomyosis. Hum Reprod 1997; 12: 1275-1279.
Zaloudek, C. and Norris, HJ. Mesenchymal tumours of the uterus. In Kurman, R.J. (ed.), Blaunstein’s Pathology of the Female Genital Tract. 3rd edn. Springer Verlag, New York 1987; 374.
Gürgüç A, Erçakmak S, Orhon E. Adenomyosis’in Klinik Önemi. Türkiye Klinikleri Tıp Bilimleri Araştırma Dergisi C.3. S.1, 1985.
Panganamamula U, Harmanli Ö, Isik-Akbay E, Grotegut C, Dandolu V, Gaughan J. Is Prior Uterine Surgery a Risk Factor for Adenomyosis? Obstet Gynecol 2004; 104: 1034-8.
Zaleski W. Pathologic and clinical aspects of adenomyosis and endometriosis. Am J Obstet Gynecol 1940; 39: 95-9.
Botsis D, Kassanos D, Antoniou G, Pyrgiotis E, Karakitsos P, Kalogirou D. Adenomyoma and Leiomyoma with Transvaginal Sonography. J Clin Ultrasound 1998; 26: 21-25
Vora IM, Raizada RM, Rawal MY, Chadda JS. Adenomyosis. J Postgrad Med 1981; 27: 7–11.
Togashi K, Ozasa H, Konishi I, Itoh H, Nishimura K, Fujisawa C, Noma A, Sagoh A, Minami S, Yamashita E, Nakano O, Konishi U, Mori T, Enlarged Uterus: Differentiation between Adenomyosis and Lelomyoma with MR Imaging. Radiology 1989; 171: 531-534
Vercellini P, Ragni G, Trespidi L, Oldani S, Panazza S, Crosignani PG. Adenomyosis: a déjà vu? Obstet Gynecol Surv 1993; 48: 789 -794.
Bromley B, Shipp T, Benacerraf B. Adenomyosis: sonographic findings and diagnostic accuracy. J Ultrasound Med 2000; 19: 529–534.
Mark, SA, Hricak H, Heinrichs LW. Adenomyosis and Leiomyoma: Differential Diagnosis with MR Imaging. Radiology 1987; 163: 527-529.
Pata Ö, Tok E, Arslan M, Dilek U, Aydın Ö, Gürbüz A, Dilek S. Adenomyozis Tanısında Transvajinal Ultrasonografinin Yeri. Artemis 2004; 5(2): 135-138.
Andreotti R, Fleischer A. The Sonographic Diagnosis of Adenomyosis 2005; 21: 167-170.
. Takahashi K, Nagata H, Kitao M. Clinical usefulness of determination of estradiol level in the menstruel blood for patients with endometriozis. Acta Obstet Gynecol Jpn 1989; 41: 1849-1850.
Urabe M, Yamamoto T, Kitawaki J. Estrogen biosynthesis in human uterine adenomyosis. Acta Endocrinol (Copenhagen) 1989; 121: 259-264.
Cohen I, Beyth Y, Shapira J. High frequency of adenomyosis in postmenopausal breast cancer patients treated with Tmoxifen. Gynecol Obstet Invest 1997; 44: 200-205.
Zehra Sema Özkan1, Banu Kumbak1, Hasan Cilgin1, Mehmet Simsek1 & Bilge Aydin Turk2 Gynecological Endocrinology, 2012; 28(3): 212–215 Copyright © 2012 Informa UK, Ltd. ISSN 0951-3590 print/ISSN 1473-0766 online DOI: 10.3109/09513590.2011.593669
Bhatt RV. Adenomyosis uteri. A critical study with an analysis of the five years' cases. J Obst & Gynaec India 1960; 11: 137-145.
Israel SL and Woultersz TB. Adenomyosis - A neglected diagnoses. Obstet & Gynaecol 1959; 14: 168-173.
Curtis KM, Hillis SD, Marchbanks PA, Peterson HB. Disruption of the endometrial-myometrial border during pregnancy as a risk factor for adenomyosis. Am J Obstet Gynecol 2002; 187: 543-4.
Levgur M, Abadi MA, Tucker A. Adenomyosis: symptoms, histology and pregnancy terminations. Obstet Gynecol 2000; 95: 688-91.
Jamieson DJ, Steege JF. The prevelence of dysmenorrhea, dyspareunia, pelvic pain, and irritable bowel syndrome in primary care practices. Obstet Gynecol 1996; 87: 55-58.
Zondervan KT, Yudkin PL, Vessey MP. Chronic pelvic pain in the community: symptoms, investigations, and diagnoses. Am J Obstet Gynecol 2001; 184: 1149-1155.
Kilkku P, Erkkola R, Gronroos M. Nonspecifity of symptoms related to adenomyosis. A prospective comporative survey. Acta Obstet Gynecol Scand 1984; 63: 229-231.
Sammour A, Pirwany I, Usubutun A. Correlations between extent and spread of adenomyosis and clinical symptoms. Gynecol Obstet Invest 2002; 54: 213-216.
Takeuchi H, Kitade M, Kikuchi I. Laparascopic adenomyomectomy and hysteroplasty: a novel method. J Minim Invasive Gynecol 2006; 13: 150- 154.
Grimbizis GF, Mikos T, Zepiridis L. Laparascopic excision of uterine adenomyomas. Fertil Steril 2008; 89: 953-961.
McCarthy S. Magnetic resonance imaging in the evaluation of infertile women. Magn Reson Q 1990; 6: 239-249.
Mathias SD, Cupperman M, Liberman RF, Lipschutz RC, Steege JF. CPP prevalance health related qualitiy of life and economic correlates Obstet – Gynecol 1996; 87: 321 – 327.
Lee NC, Dıcker RC, Rubin GL. Ory HW. Confirmation of the preoperative diagnosis for hysterectomy Am J Obstet Gynecol 1984; 150: 283 –287.
Dicker RC, Greenspan JR, Straus LT. Complications of abdominal and vaginal Lysterectomy among women of reproductive age in the United States. Am J Obstet Gynecol 1992; 144: 841 – 848.
Carlson KJ, Miller BA, Fowler FJ. Jr The maine Women’s Health Study. outcomes of hysterectomy. Obstet Gynecol 1994; 83: 556-65.
Hillis SD, Marchbanks PA, Peterson HB. The effectivenes of hysterectomy for CPP. Obsest Gynecol 1995; 86(6): 941-945.
Reiter RC, Gambone JC. Demografic and historical variables in women with CPP. Obstet Gynecol 1990; 75: 428 – 432.
Zondervan KT, Yudkin PL, Vessey MP. Chronic pelvic pain in the community: Symptoms, investigations and diagnoses Am J Obstet Gynecol 2001; 184: 1149 –55.
Çiçek N, Mungan T. Klinikte Obstetrik ve Jinekoloji Güneş Ktb 2007; Kısım 5, Bölüm 85 syf: 833-85, Bölüm 86; syf: 965-973.
Kisnisçi HA, Göksin E, Durukan T, Üstay K, Ayhan A, Gürgan T, Önderoglu LS. Jinekolojik kanamalar. In Durukan T (eds): Temel Kadın Hastalıkları ve Dogum Bilgisi Güneş Kitabevi, İstanbul 754–60, 1996.
Brenner PF. Differential diagnosis of abnormal uterine bleeding. Am J Obstet Gynecol 1996; 175: 766–9.
Paul F, Brenner MD. Differential diagnosis of abnormal uterine bleeding. Am J Obstet Gynecol 1996; 175: 766-9.
Spatt SD and Brooklyn NY. Adenomyosis of the uterus. A study of 52 reported cases and a review of the literature. Am J Obstet & Gynaec 1946; 52: 581-587.
Bayly MA and Yates CJ. Adenomyosis and abnormal uterine bleeding Obstet & Gynec 1957; 10: 276-278.
Rock AJ, Jones WH (eds). Te Linde’s Operative Gynecology 9th ed. Chap 30. Philadelphia: Wiliams & Wilkins Lippincott 2003; 753-98.
Gürbüz T. , Sefa Kurt2 , Ömer Demirtaş3 , İbrahim Uyar4 , Gülşah Demirtaş5 , Abdullah Taşyurt4 Jinokoloji - Obstetrik ve Neonatoloji Tıp Dergisi 2015; Volum:12, Sayı:1, Sayfa: 35 - 38 The Journal of Gynecology - Obstetrics and Neonatology
Yayınlanan
Lisans
LisansBu İnternet Sitesi içeriğinde yer alan tüm eserler (yazı, resim, görüntü, fotoğraf, video, müzik vb.) Akademisyen Kitabevine ait olup, 5846 sayılı Fikir ve Sanat Eserleri Kanunu ve 5237 sayılı Türk Ceca Kanunu kapsamında korunmaktadır. Bu hakları ihlal eden kişiler, 5846 sayılı Fikir ve Sanat eserleri Kanunu ve 5237 sayılı Türk Ceza Kanununda yer alan hukuki ve cezai yaptırımlara tabi olurlar. Yayınevi ilgili yasal yollara başvurma hakkına sahiptir.
