Laparoscopic Radiofrequency Thermal Ablation for Uterine Adenomyosis

Scarperi, S.; Pontrelli, Giovanni; Campana, Claudia; Steinkasserer, Martin; Ercoli, Alfredo; Minelli, Luca; Bergamini,; Ceccaroni, Marcello

doi:10.4293/jsls.2015.00071

Cited by 26 publications

(13 citation statements)

References 35 publications

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“…9 For superficial adenomyosis, using endoscopic endometrial ablation is preferred. 5,51 The coexistence of uterine fibroids and adenomyosis in 1 patient could complicate the diagnosis as the have a similarity in symptoms. Thus, in both pathologies uterine artery embolization (UAE) is performed.…”

Section: Treatmentmentioning

confidence: 99%

Current facts constituting an understanding of the nature of adenomyosis

Aleksandrovych¹,

Basta²,

Gil³

2018

Adv Clin Exp Med

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Adenomyosis seems to be the most widespread coexistent pathology included under the umbrella of common benign disorders of the human uterus. The incidence of adenomyosis is under discussion since different imaging criteria are used. In the majority of cases, prevalence is determined among women with uterine fibroids and endometriosis or severe gynecological symptoms. This common benign pathology is asymptomatic in 1/3 of cases. Up to 50% of women with infertility are affected by adenomyosis. It seems to be an important risk factor for spontaneous pre-term delivery and pre-term premature rupture of the membranes. Nowadays, the etiology of adenomyosis is still unclear and requires deeper investigation. This review summarizes the aspects of prevalence, coexistence , risk factors, classification, mechanisms of pathogenesis, genes and immunological features, main histological features, animal models, and clinical manifestation of adenomyosis. It might facilitate understanding of the independent nature of such a dual enigma as adenomyosis.

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Section: Treatmentmentioning

confidence: 99%

Current facts constituting an understanding of the nature of adenomyosis

Aleksandrovych¹,

Basta²,

Gil³

2018

Adv Clin Exp Med

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“…Although radiofrequency ablation (RFA) is not widely used for treating adenomyosis yet, laparoscopic RFA as a conservative treatment for uterine nodular adenomyosis has been reported. 19 Hai et al also showed the safety and efficacy of transcervical RFA for adenomyosis. 20 In South Korea, RFA had been accepted as an alternative treatment for uterine myoma and adenomyosis.…”

Section: Introductionmentioning

confidence: 98%

Pregnancy and symptomatic relief following ultrasound‐guided transvaginal radiofrequency ablation in patients with adenomyosis

Nam¹

2019

J of Obstet and Gynaecol

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Aim To report the reproductive results and symptomatic relief of patients with adenomyosis who attempted to conceive after ultrasound‐guided radiofrequency ablation (RFA). Methods Of 182 consecutive patients with adenomyosis who had undergone RFA, only 81 patients were eligible for this study. Pregnancy outcomes, postoperative complications, preoperative and postoperative pictorial blood loss assessment chart scores, and pain scores were evaluated. Results Of these 81 patients, 74 were infertile and seven were single at the time of RFA. The mean age at the time of operation was 35.8 years. The mean duration from the time of RFA to conception was 18.9 months (range, 2–72 months). Fifty‐nine patients tried natural conception, while 22 patients attempted conception with assisted reproductive techniques. Twenty‐nine (35.8%) patients achieved 39 pregnancies. Except for the 23 patients who did not actively try to conceive and who inevitably or arbitrarily discontinued pregnancy attempts, the pregnancy success rate reached 50%. Twenty‐two (84.6%) of the 29 patients delivered 24 (66.7%) live babies (nine vaginal deliveries and 15 cesarean sections). Twelve (33.3%) pregnancies ended in spontaneous abortions. No uterine ruptures occurred. Paired sample t‐tests revealed that preoperative pictorial blood loss assessment chart and pain scores were significantly (P < 0.05) different from the postoperative scores at 1‐, 3‐ and 6‐months. Conclusion RFA could be considered a minimally‐invasive treatment option for patients with adenomyosis who desire to maintain fertility and alleviate symptoms.

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“…Minimally invasive laparoscopic surgery is the mainstream of modern surgery; however the surgeon could not access lesions in the uterus and deep lesions are easily missed [ 12 , 17 , 18 ]. In addition, the extent of resection is definitely less than that of laparotomy and suture and haemostasis is also quite difficult, resulting in a relatively high postoperative recurrence rate [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

A New Surgical Method of U-Shaped Myometrial Excavation and Modified Suture Approach with Uterus Preservation for Diffuse Adenomyosis

Jun-Min

Zhu

Zhao

et al. 2018

BioMed Research International

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Objective To evaluate the feasibility, safety, and efficacy of a new surgical method of U-shaped myometrial excavation and modified suture approach with uterus preservation for diffuse adenomyosis. Methods From January 2012 to December 2014, 198 patients with diffuse adenomyosis were surgically treated using this novel procedure in Zhengzhou Hua-Shan Hospital. Degree of dysmenorrhea, menstrual blood volume, serum CA 125, and uterine size before and at 1 month, 3 months, 6 months, 12 months, and 24 months after surgery were compared. Results Postoperatively, VAS score of dysmenorrhea, menstrual blood volume, serum CA 125 level, and uterine size significantly decreased at 1 month, 3 months, 6 months, 12 months, and 24 months from presurgical levels (all p < .001), but there were no differences at the follow-up time points. Two patients recurred at 18 months and 23 months after surgery, but both recovered after repeat surgery. Interestingly, 2 other patients recrudesced at 10 months and 12 months after surgery. In addition, only one patient was found to have a postoperative anaemia with fever, conservatively managed without surgery. Conclusion U-shaped myometrial excavation and modified suture approach with uterus preservation is a safe and feasible surgical approach to treat diffuse adenomyosis, with favourable outcomes.

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Laparoscopic Radiofrequency Thermal Ablation for Uterine Adenomyosis

Cited by 26 publications

References 35 publications

Current facts constituting an understanding of the nature of adenomyosis

Current facts constituting an understanding of the nature of adenomyosis

Pregnancy and symptomatic relief following ultrasound‐guided transvaginal radiofrequency ablation in patients with adenomyosis

A New Surgical Method of U-Shaped Myometrial Excavation and Modified Suture Approach with Uterus Preservation for Diffuse Adenomyosis

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