TUBAL LIGATION AND ADENOMYOSIS: EXPLORING A POSSIBLE ASSOCIATION AND ITS CLINICAL IMPLICATIONS

Abstract

Adenomyosis is a gynecological condition that has attracted increasing attention in recent decades, especially in relation to its possible link to tubal ligation. In view of this reality, the objective of this article is to explore and synthesize the main academic contributions and to verify whether there is a relationship between the appearance of adenomyosis after tubal ligation, postulating the hypothesis described here as the "myometrial discovery theory". To this end, the research used a comprehensive literature review, prioritizing contemporary studies between 1980 and 2025. The analysis included titre screening, detailed reading, and extraction of relevant information on adenomyosis, tubal ligation, and hormonal and endothelial changes. Potential complications of tubal ligation include post-tubal ligation syndrome (PTS), which has symptoms similar to those of adenomyosis, chronic pelvic pain, menstrual cycle irregularity, and dyspareunia. The irreversibility of the procedure can also impact emotional health, especially in younger women who later regretted the decision. The results indicate that, after tubal ligation, there may be an increase in intrauterine pressure, which, in turn, favors the penetration of blood and fragments of endometrial tissue into the myometrial system, contributing to the development of adenomyosis. Additionally, the hormonal and endothelial changes associated with the procedure can aggravate the symptoms and progression of the condition. The complexity of the interactions between tubal ligation and adenomyosis underscores the importance of comprehensive preoperative counseling. Educating patients about risks, benefits, and contraceptive alternatives is essential for informed decisions. Clinical management of these patients requires care monitoring and individualized approaches. This study concludes that the relationship between tubal ligation and adenomyosis deserves clinical and scientific attention, indicating the need for further investigations to elucidate the mechanisms involved and the implications for female reproductive health, contributing to the development of more effective preventive and therapeutic strategies.