Design: prospective observational study

Setting: Three non-affiliated outpatient facilities

Patients or Participants: 92 premenopausal women ages 18-55 presenting for ultrasounds indicated by abnormal uterine bleeding, dysmenorrhea, dyspareunia, pelvic pain or infertility.

Interventions: All patients completed a written survey about their symptoms utilizing the VAS scale to score symptoms of pelvic pain, dysmenorrhea, dyspareunia, bowel, and bladder symptoms, and a PBAC survey to assess their menstrual blood loss. Pelvic ultrasounds were assessed blinded by two researchers utilizing a recently validated ultrasound staging system for non-invasive diagnosis and staging of adenomyosis.

Measurements and Main Results: 92 patients met inclusion criteria with a mean age of 38. Patients were predominantly white, non hispanic. 29.3% of women were nulliparous. The mean BMI was 29.8. When looking at dysmenorrhea, abnormal uterine bleeding, pelvic pain, dyspareunia, and/or infertility, there does not appear to be any statistically significant difference between women scored mild, moderate or severe disease in relation to their VAS score, however there is a trend towards higher PBAC scores in women that scored with moderate to severe disease. There appears to be strong interrater reliability between two blinded researchers when comparing the ultrasound staging system.

Conclusion: Our study revealed that the extension of disease appears to correlate more with bleeding scores however it does not have a correlation with severity of symptoms. Larger studies may show a stronger association, however there appears to be good interrater reliability with the ultrasonographic scoring system.