Adenomyomectomy with TOUA could be a safe and effective surgical method in women with symptomatic diffuse uterine adenomyosis to preserve fertility.

Topical lidocaine patches at the laparoscopic port sites reduced postoperative pain, particularly postoperative wound pain after gynecological laparoscopic procedures.

Conservative surgery is effective to reduce the symptoms of adenomyosis regardless of approach method. For near-complete excision of adenomyosis, the diffuse type is recommended to be treated with laparotomic adenomyomectomy, and focal lesions less than 5 cm can be treated with laparoscopic conservative surgery.

Laparoscopic adenomyomectomy with TOUA could be a safe and effective surgical method for women with symptomatic uterine adenomyoma who want to preserve their fertility.