Uterus sparing operative treatment for adenomyosis

This is systematic review of uterus-sparing surgical treatment options for adenomyosis finds the techniques are feasible and efficacious for management of symptoms and preservation of fertility.

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Authors

Grigoris F. Grimbizis, M.D., Ph.D., Themistoklis Mikos, M.D., M.Sc., Ph.D., Basil C. Tarlatzis, M.D., Ph.D.

Volume 101, Issue 2, Pages 472-487.e8, February 2014

Abstract

Objective:

To review systematically the literature on uterus-sparing surgical treatment options for adenomyosis.

Design:

Systematic literature review.

Setting:

Tertiary academic center.

Patient(s):

Women with histologically proven adenomyosis treated with uterus-sparing surgical techniques.

Intervention(s):

Conservative uterine-sparing surgery for adenomyosis classified as (1) complete excision of adenomyosis, (2) cytoreductive surgery or incomplete removal of the lesion, or (3) nonexcisional techniques, with studies selected if women with adenomyosis were treated surgically without performing hysterectomy.

Main Outcome Measure(s):

The cure rate after interventional strategies, the rate of symptom (dysmenorrhea and menorrhagia) control, and pregnancy rate in each group of intervention.

Result(s):

A quality assessment tool was used to assess the scientific value of each study. In total, 64 studies dealing with 1,049 patients were identified. After complete excision, the dysmenorrhea reduction, menorrhagia control, and pregnancy rate were 82.0%, 68.8%, and 60.5%, respectively. After partial excision, the dysmenorrhea reduction, menorrhagia control, and pregnancy rate were 81.8%, 50.0%, and 46.9%, respectively.

Conclusion(s):

Uterine-sparing operative treatment of adenomyosis and its variants appear to be feasible and efficacious. Well-designed, comparative studies are urgently needed to answer the multiple questions arising from this intriguing intervention.

Read the full text at: http://www.fertstert.org/article/S0015-0282(13)03171-3/fulltext


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.

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