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.

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Volume 109, Issue 3, Pages 406–417

Authors:

Hisao Osada, M.D., Ph.D.

Abstract:

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.


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

2 Comments

Go to the profile of Wenjie Yan
Wenjie Yan 10 months ago

Dear, Hisao Osada, M.D., Ph.D.

     It's a great honor for me to read your article“Uterine adenomyosis and adenomyoma: the surgical approach”.I benefit a lot from this article. Now we are writing the consensus of Chinese experts on adenomyosis with infertility.  In our consensus, We want to quote figures 1 and 3 in your article.  Of course, we will mark references in the text.  We look forward to your agreement,thank you very much.

                                                                                                                                                                               Wenjie yan, China

                                                                                                                                                                                  12.12.2019

Go to the profile of Micah J Hill
Micah J Hill 10 months ago

Wenjie yan,

Requests for permission to use figures cannot be made through this site.  You can request permission by going to the article (https://www.fertstert.org/article/S0015-0282(18)30032-3/fulltext) and clicking the “Request Permissions” link in the right column.


Sincerely,

Micah J Hill

Interactive Associate in Chief, Fertility and Sterility