Association between adenomyosis subtypes and concurrent endometrial lesions: a propensity score-matched retrospective study
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By
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Xiaoxi Niu
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Yiyi Wang
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Yijie Zhai
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Yunyan Teng
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Zhaogang Dong
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Lijie Wang
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May 29, 2026
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Clinical Scorecard: Linking Subtypes of Adenomyosis to Coexisting Endometrial Lesions: A Retrospective Study Utilizing Propensity Score Matching
At a Glance
| Category | Detail |
|---|
| Condition | |
| Key Mechanisms | Heterogeneous syndrome with focal and diffuse subtypes; associated with hormonal dysregulation and chronic inflammation. |
| Target Population | |
| Care Setting | |
Key Highlights
- Study included 685 patients with confirmed adenomyosis.
- Diffuse adenomyosis (Di-ADS) associated with a higher incidence of endometrial lesions (49.5% vs. 35.6%).
- After propensity score matching, Di-ADS remained a significant risk factor for endometrial lesions (aOR = 2.05).
- Stronger association for women aged ≤45 years (P <.001).
Guideline-Based Recommendations
Diagnosis
- Pathological confirmation of adenomyosis based on hysterectomy or adenomyoma excision specimens.
Management
- Consider endometrial surveillance for patients with diffuse adenomyosis.
Monitoring & Follow-up
- Monitor for coexisting endometrial lesions, especially in younger women.
Risks
- Increased risk of endometrial lesions in patients with diffuse adenomyosis.
Patient & Prescribing Data
Women with confirmed adenomyosis, particularly those with diffuse subtype.
Management strategies should be informed by the risk of concurrent endometrial lesions.
Clinical Best Practices
- Utilize propensity score matching to minimize selection bias in studies.
- Assess severity of dysmenorrhea and pelvic pain using standardized scales.
- Ensure comprehensive data extraction from medical records for accurate diagnosis.
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