Incidence of Adenomyosis in Hysterectomy Specimens Performed for Benign Uterine Pathologies: A Six-Year Retrospective Analysis from a Tertiary Center in Romania

Background/Objectives: Adenomyosis is a common yet frequently underdiagnosed cause of gynecological morbidity, and its definitive diagnosis still relies on histopathological examination of hysterectomy specimens. We aimed to determine the histopathological prevalence of adenomyosis in hysterectomy specimens removed for benign indications, characterize preoperative referral diagnoses and concurrent histopathological findings, and compare our results with the contemporary literature.

Methods

We retrospectively analyzed 430 consecutive abdominal hysterectomies performed for benign gynecological indications at a tertiary referral center in Iasi, Romania, between January 2019 and October 2024. Adenomyosis was defined histopathologically. An “incidental” finding was defined as the absence of adenomyosis in the preoperative referral diagnosis, without re-review of the original ultrasound reports. We report prevalence and the incidental rate with Wilson-score 95% confidence intervals (CIs); we used the chi-square test with Yates continuity correction for categorical comparisons and calculated odds ratios (ORs), with correction for multiple comparisons.