Combined Results of New Surgery Approach and Hormone Therapy with Massive Diffuse Forms of Adenomyosis

Abstract

The advised treatment for severe adenomyosis is hysterectomy, but the patients wishing to preserve their uterus were operated with a novel conservative surgery, called adenomyomectomy. The history of this new surgery approach dates back to 2011 when Japanese Professor Hisao Osada worked it out and applied this new method of surgery for his patients. Adenomyomectomy, in this method, suggests radically excised adenomyotic tissues and reconstructed uterine wall by a triple-flap method, without overlapping suture lines, to prevent uterine rupture in subsequent pregnancies. This is a prospective case series followed for 6 years from October 2012 to January 2018 of 26 women with massive diffuse adenomyosis verified histologically and diagnosed with ultrasound. 18 women of 26 wished to conceive; 3 patients became spontaneous pregnant and delivered healthy babies. There were no cases of uterine rupture. Adenomyosis symptoms did not recur in all 26 cases. Thus, our experience of intraoperative radical resection of adenomyotic tissues suggests that this technique may be a surgery of the patient's choice, especially for women of reproductive age with diffuse adenomyosis, we use it for those aging ones who wish to preserve the uterus.