Razavi Journal of Medicine

Razavi Journal of Medicine

Prevalence of Adenomyosis in Hysterectomy Specimens from Patients with Benign Gynecological Conditions

Articles in Press

Document Type : Original Article

Authors
Taraneh Mohajeri 1
Sajad Moosavi 2
Zahra Mostafavian 3
1 Department of Gynecology, Faculty of Medicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran.
2 . Innovative Medical Research Center, Faculty of Medicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran.
3 Department of Community Medicine, Faculty of Medicine, Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran.
10.30483/rjm.2026.254664.1436
Abstract
Background: Adenomyosis is defined by the ectopic presence of endometrial tissue within the myometrium. The reported histopathological prevalence in hysterectomy specimens varies substantially (8.8–61.5%), and associated risk factors remain a subject of debate.

Objectives: This study aimed to determine the prevalence of adenomyosis in hysterectomy specimens obtained for benign gynecological indications and to evaluate its association with key demographic and clinical variables.

Methods: This cross-sectional investigation (2023–2025) consecutively enrolled 99 women who underwent hysterectomy for benign conditions at hospitals affiliated with Mashhad Medical Sciences, Islamic Azad University. Patients with gynecological malignancies or incomplete medical records were excluded. Demographic and obstetric data, including age, body mass index (BMI), educational attainment, gravidity, parity, mode of delivery, and history of abortion, were systematically recorded. Adenomyosis was diagnosed through histopathological examination. Following assessment of normality using the Shapiro–Wilk test, continuous variables were compared using the independent-samples t-test, and categorical variables were analyzed using the chi-square test (statistical significance set at p < 0.05).

Results: Adenomyosis was histologically confirmed in 36 women (36.4%). The mean age of the cohort was 55.3 ± 10.4 years, and the mean BMI was 27.7 ± 3.7 kg/m². Women diagnosed with adenomyosis exhibited a significantly higher mean BMI compared to those without the condition (30.1 ± 3.0 vs. 26.3 ± 3.4 kg/m²; p < 0.001). In the categorical analysis, adenomyosis was absent in all participants with a normal BMI (<25 kg/m²) but was identified in 38.3% of overweight women and 58.1% of obese women (p < 0.001). No statistically significant associations were observed between adenomyosis and age, gravidity, parity, mode of delivery, history of abortion, or educational level.

Conclusion: Adenomyosis was present in over one-third of hysterectomy specimens obtained for benign indications. Elevated BMI emerged as the sole significant risk factor associated with the condition, highlighting overweight and obesity as potentially modifiable contributors to adenomyosis pathogenesis.
Keywords
Adenomyosis
Body Mass Index
Hysterectomy
Benign Gynecologic Diseases
Risk Factors

Subjects

Acknowledgements: We extend our sincere gratitude to all patients who participated in this study. We also wish to thank the staff and experts of the Research Centre of Mashhad Medical Sciences, Islamic Azad University, particularly Dr. Tooraj Zandbaf, Vice President for Research, for their invaluable technical support and assistance during the preparation of this manuscript. Finally, we appreciate the contributions of all individuals who supported the completion of this research.

Conflicts of interests: The authors declare no conflicts of interest.

Ethical Considerations: This study was reviewed and approved by the Research Ethics Committee of Mashhad Islamic Azad University of Medical Sciences (Approval Code: IR.IAU.MSHD.REC.1402.190). Written informed consent was obtained from all individual participants included in the study. All procedures performed were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments. Patient data confidentiality was strictly maintained, and participants retained the right to withdraw from the study at any time without consequence. 

Financial disclosure: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author contributions: Conceptualization: Taraneh Mohajeri (TM); Methodology and Formal analysis: Zahra Mostafavian (ZM), Sajad Moosavi (SM); Investigation and Data curation: Sajad Moosavi (SM); Writing – Original draft: Sajad Moosavi (SM); Writing – Review & Editing: Taraneh Mohajeri (TM), Sajad Moosavi (SM). All authors have read and approved the final version of the manuscript and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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Razavi Journal of Medicine

Articles in Press, Accepted Manuscript
Available Online from 04 May 2026