Uterine adenomyosis and adenomyoma: the surgical approach
A review of post-1990 surgical treatments for adenomyosis, including laparotomic and laparoscopic surgeries, focusing on the uterine rupture outcomes that occurred during post-adenomyomectomy pregnancies.
Volume 109, Issue 3, Pages 406–417
Hisao Osada, M.D., Ph.D.
The appropriate surgical treatment of adenomyosis, a benign invasion/infiltration of endometrial glands within the underlying myometrium, remains a subject of discussion. Since 1990, in place of the classical V-shaped resection method, various kinds of surgical management have been attempted, including a uterine muscle flap method that emphasizes fertility preservation, an asymmetric dissection method, and various modified reduction methods. Laparoscopic adenomyomectomy has also become an alternative to laparotomy for surgically managing the focal type of adenomyosis, although it seems to be associated with a higher risk of uterine rupture than laparotomy. This article reviews the surgical treatment of adenomyosis, including 23 uterine rupture cases that occurred during post-adenomyomectomy pregnancies, and provides an updated picture of the state of the field.