What question did this study set out to answer?

To compare uterine and cervical morphology between women with acromegaly and healthy controls, investigating cervical hypertrophy.

March 25, 2026Open Access

Acromegalic Uteropathy: Specific Uterine Ultrasound Findings in Female Patients

Key Points

To compare uterine and cervical morphology between women with acromegaly and healthy controls, investigating cervical hypertrophy.
Retrospective case-control study of reproductive-age women
Pelvic ultrasound performed on three groups: acromegaly, healthy controls, adenomyosis
Cervical and uterine measurements obtained via transabdominal and transvaginal ultrasound
Volumes calculated using the ellipsoid formula; U:C volume ratio analyzed
Group differences tested with Mann–Whitney tests and Bonferroni correction.
Cervical dimensions (length, width, thickness, volume) were significantly larger in acromegaly compared to healthy controls
U:C volume ratio was reduced in acromegaly, indicating disproportionate cervical enlargement
Compared to adenomyosis, acromegaly also had larger cervical width and thickness, suggesting a distinct pattern of hypertrophy.

Abstract

Background/Objectives: Acromegaly is a systemic connective tissue disease driven by chronic growth hormone (GH) and insulin-like growth factor-1 (IGF-1) excess; yet, the female reproductive tract—especially the extracellular matrix (ECM)-rich cervix—has been poorly studied. We aimed to compare uterine and cervical morphology in women with acromegaly versus healthy controls and a gynecologic disease comparator, testing the hypothesis of selective cervical hypertrophy. Methods: We performed a retrospective case–control study of reproductive-age women who underwent pelvic ultrasound: acromegaly (n = 33), healthy controls (n = 45), and adenomyosis without acromegaly (n = 44). Uterine body measurements were obtained by TAUS/TVUS; cervical biometry was performed transvaginally in all cases. Volumes were estimated using the ellipsoid formula, and a uterus-to-cervix (U:C) volume ratio was calculated. Group differences were analyzed with Mann–Whitney tests and Bonferroni correction. Results: A total of 122 women were included. Uterine body length, width, AP size, and volume did not differ between acromegaly and either comparison group (all p-values non-significant). In contrast, cervical length, width, AP thickness, and volume were significantly higher in acromegaly than in healthy controls, with a corresponding reduction in the U:C volume ratio, indicating disproportionate cervical enlargement. Compared with adenomyosis, women with acromegaly again showed larger cervical width, AP thickness, and volume, together with altered U:C indices, whereas cervical length did not differ, suggesting a pattern not explained by nonspecific pelvic pathology. Conclusions: Women with acromegaly demonstrate a distinct uterine phenotype characterized by selective cervical hypertrophy with preserved uterine corpus size—an ECM-centric “acromegalic uteropathy.” This noninvasive morphometric signature may have diagnostic and procedural relevance and warrants confirmation in prospective studies.

Acromegalic Uteropathy: Specific Uterine Ultrasound Findings in Female Patients

Key Points

Abstract

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