Location of adenomyosis in total hysterectomy specimens

Study Objective. To determine the location of adenomyosis in hysterectomy specimens and estimate a risk of leaving the disease in patients undergoing supracervical hysterectomy. Design. Retrospective cohort study (Canadian Task Force classification II-2). Setting. University teaching hospital. Subjects. Total hysterectomy specimens from 32 women. Measurements and Main Results. Each patient had six slides representing anterior and posterior cuts of the uterus at the cervix, lower uterine segment, and fundus. Analyzing the six groups separately, no significant difference was seen in the number of nests between anterior and posterior slides at the same uterine level. A substantial difference was noted between each site and all other sites on other uterine levels. Grouping the anterior and posterior together, a significant difference was found in the number of nests between all levels (p <0.001). Evaluating only for presence of disease, no significant difference was found between the anterior and posterior of each level, a significant difference was seen between each site and sites at all other levels, and a difference was noted among all levels when the anterior and posterior were grouped (all p <0.001). Conclusion. Adenomyosis has a significant propensity to be present in the uterine fundus but it is extremely rare in the cervix. Supracervical hysterectomy for adenomyosis is unlikely to leave disease in the patient as long as the entire lower uterine segment is excised.