UT Southwestern review reveals preventable hysterectomy for common gynecologic condition: newsroom

DALLAS – September 10, 2021 – Adenomyosis – an abnormal tissue growth in the muscular wall of the uterus that causes painful cramping and heavy or prolonged menstrual bleeding – is more common than commonly believed, according to a review by literature performed by gynecologists at UT Southwestern Medical Center revealed.

Kimberly A. Kho, MD, Assistant Chief of Gynecology at William P. Clements Jr. University Hospital, UTSW

Up to 1 in 3 women have adenomyosis, which should be considered in the differential diagnosis of abnormal uterine bleeding and / or pelvic pain, the researchers noted. Considered a common uterine condition, the syndrome often goes undiagnosed until it results in a hysterectomy, although surgery may be preventable for some women, according to results published in JAMA Network. Researchers identify several medical therapies and uterine sparing procedures that can effectively improve symptoms without the need for a hysterectomy.

“A lot of women come to me and tell me the only solution they’ve ever been offered is a hysterectomy. Other low cost, low risk options such as medical management or less invasive options have been around for over 20 years, ”said lead author. Kimberly A. Kho, MD, deputy head of Gynecology at UTSW William P. Clements Jr. University Hospital and member of Lowe Foundation Center for Women’s Preventive Health Care at UT Southwestern.

Modern ultrasound and MRI, combined with a pelvic exam, can often detect the disease, Dr Kho said. She and her colleagues have encouraged greater awareness of this disease – as well as a related disease, endometriosis – including among school nurses, who are often the first contact for young women who are starting their period. Social traditions can mistakenly teach women from an early age that heavy bleeding and pain during menstruation is normal, but these symptoms if left untreated can intensify over time, causing blood loss to decrease. quality of life, pain during intercourse and fertility problems.

“Doctors often consider adenomyosis to be a condition of women in their 40s and 50s because that’s when they have their womb removed and diagnosed, but it develops much earlier. “, said Dr Kho, a former National Institutes of Health-supported clinical researcher who serves as an expert for several national organizations, including the American College of Obstetricians and Gynecologists (ACOG), the Food and Drug Administration (FDA), and the Centers for Disease Control and Prevention (CDC). “Better clinical awareness is needed to ensure appropriate patient care and to encourage further studies to improve understanding of adenomyosis.”

No FDA-approved medical therapy is specifically indicated for the treatment of adenomyosis, but the condition can be managed using drugs developed for birth control or for symptoms of other gynecological conditions such as fibroids or fibroids. endometriosis. Further clinical and pathological studies are needed, noted the authors, particularly on the ages and ethnicities most frequently affected, and on what the disease can tell us about uterine cancer.

Dr. Kho holds the Helen J. and Robert S. Strauss and Diana K. and Richard C. Strauss Chairs in Women’s Health. The disclosures are listed in the document.

About UT Southwestern Medical Center

UT Southwestern, one of the nation’s leading academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty has been awarded six Nobel Prizes and includes 25 members of the National Academy of Sciences, 16 members of the National Academy of Medicine and 13 researchers of the Howard Hughes Medical Institute. The more than 2,800 full-time faculty are responsible for groundbreaking medical advancements and are committed to having physicians in the Southwest provide care in approximately 80 specialties to more than 117,000 inpatients, over 360 000 cases in the emergency room and supervise nearly 3 million outpatient visits per year.

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