188 women (n=3) were noted during menstruation and the mid-luteal phase (252). Nishino et al. (2005) showed a fundocervical contraction direction during menses in all patients with leiomyomas (n=26). The location of the leiomyomas seemed to be of no statistically significant influence (250). After treatment of uterine leiomyomas by either UAE or USgHIFU, the cervicalfundal movement during the periovulatory phase remained unchanged (247,258). Additional peristaltic observations A case-control study reported that 33% of the patients (n=9/16) with submucosal leiomyomas had disturbed uterine peristalsis. Specifically, higher frequency focal myometrial movements in the immediate vicinity of the leiomyoma were observed (250). After treatment of uterine leiomyomas with UFE, uterine contractions were noted to become more coordinated (251). Adenomyosis/Endometriosis and uterine peristalsis Five studies investigated uterine peristalsis in adenomyosis/endometriosis patients, with two studies using IUP catheter measurement, one TVUS and HSSG, one only HSSG, and one cine MRI. Presence of uterine contractions Uterine peristalsis was noted in both patients with endometriosis and healthy controls (253). Bulletti et al. (2002) confirmed the presence of uterine contractions during the menstrual phase in both patients with endometriosis (n=22) and controls (n=20) (254). In a case-control study by Kido et al. (2007), by contrast, a difference was found in the presence of uterine contractions throughout the entire menstruation cycle. During the periovulatory phase, statistically significantly fewer patients with endometriosis (n=26) had uterine contractions compared to controls (n=12). A trend towards a lower presence during the luteal phase and higher during the menstrual phase compared to controls was suggested but did not prove to be significant (245). Contraction frequency In three studies, the increase in frequency from early to late follicular phase in healthy controls was also observed amongst women with endometriosis (232,245,253,254). As reported in several studies, the contraction frequency
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